Wilma Blake Faulkner, L.AC., DIPL O.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

371 Issued in GA

Practice address

4900 Ivey Rd NW
Suite 820
Acworth, GA 30101-4001

Phone

(770) 975-9233

NPI assigned

Oct 7, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1689045353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4806 DAVENPORT TRCE NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013974",
            "telephone_number": "336-671-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 IVEY RD NW",
            "address_2": "SUITE 820",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014001",
            "telephone_number": "770-975-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "WILMA",
        "middle_name": "BLAKE",
        "name_prefix": "Mrs.",
        "credential": "L.AC., DIPL O.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "GA",
            "license": "371",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NC",
            "license": "496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Acworth, GA
• Providers in Acworth, GA by specialty
• Acupuncturist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.