Allan Marcos Faircloth, DNP, PMHNP-BC, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5014648 Issued in NC

Practice address

1901 Adams Farm Pkwy
Greensboro, NC 27407-6338

Phone

(336) 722-7266

NPI assigned

Aug 10, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saved Health IncGroup PAC ID 2860823101, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saved Health Inc

  • Addiction Psychiatry Physician
  • High Point, NC
  • NPI 1740762160

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Crossroads Treatment Center of Greensboro, PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Greensboro, NC
  • NPI 1245482793
  NPD (past)
• Wellmood PLLC

  • Psychiatry Physician
  • Winston Salem, NC
  • NPI 1154182368
  NPD (past)

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1457876591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 KING ST APT 1E",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 ADAMS FARM PKWY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274076338",
            "telephone_number": "336-722-7266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "ALLAN",
        "middle_name": "MARCOS",
        "name_prefix": "Dr.",
        "credential": "DNP, PMHNP-BC, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-10",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "271994",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5014648",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ezcare Providers Inc
• Ezcare Providers Inc.
• F&M Wellness Service LLC
• Fabkom Services Inc
• Afua Faibille
• Mary Scott Faircloth, DPT
• Regan Faircloth
• Tameka Lockette Fairfax, CMA
• Frank Patterson Fairley Jr.
• Faison Medical Care, PLLC

• Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.