Earl H Faulkner, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PHD-419 Issued in WY

Practice address

6900 Alden Dr
Cheyenne, Wy
Fe Warren Afb, WY 82005-3906

Phone

(307) 773-2998

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Family Care Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1790141984
  Medicare reassignment Care Compare group NPD
• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288

  Mental Health

  NPD

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1578784377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "CHEYENNE, WY",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR",
            "address_2": "CHEYENNE, WY",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820053906",
            "telephone_number": "307-773-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "EARL",
        "middle_name": "H",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "PHD-419",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "PHD-419",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WY",
            "license": "PHD-419",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "PHD-419",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "WY",
            "license": "PHD-419",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122963000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Cravens, LSCW
• Jessica Rae Davis, PA
• Dod Fe Warren Pharmacy
• Barbara Bridget Eakin, RN
• Emilie Lenora Elick, PSYD
• Fe Warren Medical Group
• Meaghan Endicott Georges, DNP, PNP-PC
• Dustin Gilmore Gorski
• Dan R Greenhalgh, DMD
• Nakia Joanne Halcom, BSN, RN

• Psychologist in Fe Warren Afb, WY
• Providers in Fe Warren Afb, WY by specialty
• Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.