Organization Active NPI

Faulk Family Healthcare, PLLC

  • Family Nurse Practitioner
  • Nederland, TX
National Provider Identifier
1467998401
Registry record updated Jan 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP116645 Issued in TX
Legal business name
FAULK FAMILY HEALTHCARE, PLLC
Practice address
520 S Twin City Hwy
Suite 103
Nederland, TX 77627-4245
Phone
(409) 727-1414
Fax
(409) 727-1449
NPI assigned
Jan 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2017

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

Authorized official

Name
Mrs. Sabrina Lea Faulk, FNP-BCNPI 1710155320
Title
Owner/Manager
Phone
(409) 727-1414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP116645 TX Primary

Addresses

Primary practice location

520 S Twin City Hwy
Suite 103
Nederland, TX 77627-4245

Mailing address

520 S Twin City Hwy
Suite 103
Nederland, TX 77627-4245
Phone (409) 727-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171009001091 TX Part B Supplier - Clinic/Group Practice 9436424066 Receives reassigned benefits from 1 practitioner
Practice locations: Nederland, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2073996Faulk Family Healthcare520 S Twin City Hwy Suite 103, Nederland, TX 77627Certificate of waiverFeb 26, 2028

National Provider Directory

National Provider Directory

Locations

520 S Twin City Hwy
Ste 103
Nederland, TX 77627
Phone (409) 727-1414

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484438400000",
    "number": "1467998401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S TWIN CITY HWY",
            "address_2": "SUITE 103",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274245",
            "telephone_number": "409-727-1414",
            "fax_number": "409-727-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S TWIN CITY HWY",
            "address_2": "SUITE 103",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776274245",
            "telephone_number": "409-727-1414",
            "fax_number": "409-727-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAULK FAMILY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-15",
        "last_updated": "2017-01-15",
        "status": "A",
        "authorized_official_last_name": "FAULK",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "409-727-1414",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP116645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.