Active NPI
Samantha Faulkner, ATC
- Athletic Trainer
- Gallipolis, OH
National Provider Identifier
1417365602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT.004483
- Practice address
- 1051 Fourth Avenue
Gallipolis, OH 45631 - Phone
- (855) 446-5937
- Fax
- (740) 446-5448
- NPI assigned
- Jul 31, 2014
- Last updated
- Jul 31, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT.004483 | OH | Primary |
Addresses
Primary practice location
1051 Fourth Avenue
Gallipolis, OH 45631
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (855) 446-5937
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT.004483 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406764800000",
"number": "1417365602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JACKSON PIKE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311560",
"telephone_number": "855-446-5937",
"fax_number": "740-446-5448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 FOURTH AVENUE",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "45631",
"telephone_number": "855-446-5937",
"fax_number": "740-446-5448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAULKNER",
"first_name": "SAMANTHA",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-31",
"last_updated": "2014-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT.004483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.