Nicholas Faulconer, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

91733 Issued in GA

Practice address

790 Church St NE Ste 400
Marietta, GA 30060-8957

Phone

(770) 514-2776

NPI assigned

Mar 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in VA, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Diagnostic Radiology

Education

University of Texas Southwestern Medical School at Dallas, 2016

Medicare assignment

May accept Medicare assignment

Group practices

M and B Imaging, PCGroup PAC ID 1557623782, 69 clinicians

Pro Radiology LLCGroup PAC ID 1052696432, 112 clinicians

Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
• Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
• Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
• Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 66)

Interoperability endpoints

• Direct secure messaging: nfaulconer351944@direct.healthsystem.virginia.edu

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.

• M & B Imaging, PC

  • Radiology Clinic/Center
  • Gainesville, GA
  • NPI 1932624723

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Pro Radiology, LLC

  • Radiology Clinic/Center
  • Atlanta, GA
  • NPI 1164966461
  Medicare reassignment Care Compare group NPD
• Quantum Radiology, PC

  • Diagnostic Radiology Physician
  • Marietta, GA
  • NPI 1366495988
  Medicare reassignment Care Compare group NPD
• Synergy Radiology, LLC

  • Radiology Clinic/Center
  • Conyers, GA
  • NPI 1558886341

  Diagnostic Radiology

  Medicare reassignment NPD
• University of Virginia Imaging, LLC

  • Diagnostic Radiology Physician
  • Charlottesville, VA
  • NPI 1720233596
  Medicare reassignment NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  Medicare reassignment NPD
• American Health Imaging of Georgia LLC

  • Radiology Clinic/Center
  • Newnan, GA
  • NPI 1144206764
  NPD
• American Health Imaging of Georgia LLC

  • Radiology Clinic/Center
  • Lawrenceville, GA
  • NPI 1467437327
  NPD
• American Health Imaging of Georgia, LLC

  • Radiology Clinic/Center
  • Cumming, GA
  • NPI 1346606506
  NPD
• Synergy Radiology, LLC

  • Radiology Clinic/Center
  • Douglasville, GA
  • NPI 1588229918
  NPD
• University of Virginia Imaging, LLC

  • Radiology Clinic/Center
  • Zion Crossroads, VA
  • NPI 1083055842

  Diagnostic Radiology

  NPD
• University of Virginia Imaging, LLC

  • Radiology Clinic/Center
  • Charlottesville, VA
  • NPI 1700545928

  Diagnostic Radiology

  NPD

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

• Cobb Hospital, Inc

  • General Acute Care Hospital
  • Austell, GA
  • NPI 1467420448
  Care Compare affiliation
• Douglas Hospital, Inc.

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • General Acute Care Hospital
  • Marietta, GA
  • NPI 1649248626
  Care Compare affiliation
• Paulding Medical Center, Inc.

  • General Acute Care Hospital
  • Hiram, GA
  • NPI 1457329435
  Care Compare affiliation
• Wellstar North Fulton Hospital, Inc

  • General Acute Care Hospital
  • Roswell, GA
  • NPI 1750312997
  Care Compare affiliation

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1629430285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-514-2776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608957",
            "telephone_number": "770-514-2776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229081005",
            "country_code": "US",
            "telephone_number": "434-924-9400",
            "fax_number": "434-982-1618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAULCONER",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101265469",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "91733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfaulconer351944@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1215 Lee St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229081005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nfaulconer351944@direct.healthsystem.virginia.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1215 Lee St",
            "city": "Charlottesville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "229081005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Maxwell Farrow, D.D.S.
• Amy Farthing, PT, DPT
• Farzana Badrun, M.D., P.C.
• Akintayo Fatunwase, BT
• Charmaine L Faucher, PA-C
• Valerie Marie Faulk, CRNA
• Spencer Favor
• Tacresha Favors, RBT
• Isha Faye, BS, RBT
• Donna W Fearing, MD

• Diagnostic Radiology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.