Individual provider Active NPI

Patricia Kay Faulkenberry, APRN-BC

  • Nurse Practitioner
  • Forney, TX
National Provider Identifier
1679286066
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1099674 Issued in TX
Practice address
108 E US Highway 80
Forney, TX 75126-8688
Phone
(972) 564-4444
NPI assigned
Dec 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1099674 TX
Gerontology Nurse Practitioner 363LG0600X 1099674 TX
Nurse Practitioner 363L00000X 1099674 TX Primary

Addresses

Primary practice location

108 E US Highway 80
Forney, TX 75126-8688

Mailing address

13423 Hiram Rd
Wills Point, TX 75169-8667
Phone (999) 999-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240327000274 TX Practitioner - Nurse Practitioner 8527419647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

6202 Harry Hines Blvd
Dallas, TX 75390-9293
Phone (817) 987-3955

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 28, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Dec 28, 2023 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6202 Harry Hines Blvd
Dallas, TX 75390
Phone (214) 590-2218

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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 1

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": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1679286066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13423 HIRAM RD",
            "city": "WILLS POINT",
            "state": "TX",
            "postal_code": "751698667",
            "telephone_number": "999-999-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E US HIGHWAY 80",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268688",
            "telephone_number": "972-564-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKENBERRY",
        "first_name": "PATRICIA",
        "middle_name": "KAY",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-30",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1099674",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1099674",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1099674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.