Individual provider Active NPI

Michael Todd Faulkner Jr., FNP

  • Family Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1467166983
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5020636 Issued in NC
Practice address
2365 Springs Rd NE
Hickory, NC 28601-3067
Phone
(828) 732-5550
Fax
(828) 732-5551
NPI assigned
Jan 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5020636 NC Primary

Addresses

Primary practice location

2365 Springs Rd NE
Hickory, NC 28601-3067

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-1904

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241112002234 NC Practitioner - Nurse Practitioner 0941734016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

991 W Hudson Blvd
Gastonia, NC 28052-6430
Phone (704) 853-5079

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5020636NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Health Services, Inc CurrentSince Oct 1, 2024 Accepting new patients
Gaston Family Health Services, Inc. CurrentSince Oct 1, 2024 Accepting new patients

Locations

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

2365 Springs Rd NE
Hickory, NC 28601
Phone (828) 256-2112

Interoperability endpoints

  • Direct secure messaging: michael.faulkner@cvmg.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1467166983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 SPRINGS RD NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013067",
            "telephone_number": "828-732-5550",
            "fax_number": "828-732-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "MICHAEL",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5020636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.