Austin King Fackler, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Erda, UT
NPI 1437871514 · NPPES record last updated Sep 14, 2022
Key facts
- NPI
- 1437871514
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 11081203-4405 (UT)
- Practice address
- 5132 Heidi Way
Erda, UT 84074-9246 - Phone
- (435) 773-8173
- NPI assigned
- Sep 14, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tooele Clinic Corp
Practice addresses (Care Compare)
1929 N Aaron Dr
Suite L
Tooele, UT 84074-8112
Phone (435) 843-3859
Hospital & facility affiliations
- Mountain West Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.71 of 100
- Quality
- 91.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.67
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221205002547 | UT | Practitioner - Nurse Practitioner | 3072982578 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11081203-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tooele Clinic Corp | Current |
Accepting new patients |
Locations
1929 N Aaron Dr
Tooele, UT 84074
Phone (435) 833-0229
2326 N 400 E
Ste 100
Tooele, UT 84074
Phone (435) 843-0180
1929 N Aaron Dr
Ste L
Tooele, UT 84074
Phone (435) 833-9180
2321 N 400 E
Ste 300
Tooele, UT 84074
Phone (435) 833-9180
196 E 2000 N
Ste 104
Tooele, UT 84074
Phone (435) 843-2576
Interoperability endpoints
- austin.fackler.1@1562.direct.athenahealth.com
- akfackle@yourcarecommunity.org
- austin.fackler.1@12395.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 11081203-4405 | UT | Yes |
Addresses
Primary practice location
5132 Heidi Way
Erda, UT 84074-9246
Mailing address
5132 Heidi Way
Erda, UT 84074-9246
Phone (435) 773-8173
Other providers in Erda, UT
All providers in Erda, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.