Jacob Faultersack, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

6013 Farrington Rd Ste 301
Chapel Hill, NC 27517-8173

Phone

(984) 974-6669

Fax

(984) 974-9609

NPI assigned

Apr 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jfaultersack411820@directhisp.wakemed.org
• Direct secure messaging: jfaultersack873757@direct.unc.nchie.net

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1427792290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MACNIDER HALL CAMPUS BOX 7593",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997593",
            "telephone_number": "919-966-3172",
            "fax_number": "919-966-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6013 FARRINGTON RD STE 301",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275178173",
            "telephone_number": "984-974-6669",
            "fax_number": "984-974-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULTERSACK",
        "first_name": "JACOB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy M Farrell, MD
• Carmilla Y Farrington, M.A.
• Jennifer Hanna Farrior, MS
• Aimee Faso
• Jan E Faulk Eggleston, D.D.S.
• Alyssa Fawcett, DDS
• Kayla Desiree Feagins, MD
• Mary Clayton Federspiel, CPNP
• Maya Fedhila, DDS
• George Daniel Fedoriw, M.D.

• Student in an Organized Health Care Education/Training Program in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Student in an Organized Health Care Education/Training Program in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.