Individual provider Active NPI

Felicia C Fauntleroy, RN

  • Registered Nurse
  • Baltimore, MD
National Provider Identifier
1407184096
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R187622 Issued in MD
Practice address
4007 Rosecrest Ave
Baltimore, MD 21215-3428
Phone
(443) 506-6110
Fax
(410) 585-1549
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R187622 MD Primary

Addresses

Primary practice location

4007 Rosecrest Ave
Baltimore, MD 21215-3428

Mailing address

4007 Rosecrest Ave
Baltimore, MD 21215-3428
Phone (443) 506-6110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R187622MDMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1407184096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 ROSECREST AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153428",
            "telephone_number": "443-506-6110",
            "fax_number": "410-585-1549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 ROSECREST AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153428",
            "telephone_number": "443-506-6110",
            "fax_number": "410-585-1549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUNTLEROY",
        "first_name": "FELICIA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R187622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.