Kenneth Michael Faulkner, MS, RN, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F305502-1 Issued in NY

Practice address

45 Research Way
Suite 204
East Setauket, NY 11733-6401

Phone

(631) 444-3006

NPI assigned

Mar 27, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Registered Nurse

State licenses

Practice roles

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.

• Stony Brook Internists, University Faculty Practice Corporation

  • Medical Oncology Physician
  • Stony Brook, NY
  • NPI 1184679342
  NPD (past)

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1720354434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STONY BROOK UNIVERSITY SCHOOL OF NURSING",
            "address_2": "HSC LEVEL 2",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 RESEARCH WAY",
            "address_2": "SUITE 204",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117336401",
            "telephone_number": "631-444-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "MS, RN, ANP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "234412",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NY",
            "license": "512108-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305502-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James William Every, MPT
• Eye-Q Corporation of America
• Roseann M Falcone, L.M.H.C., C.A.S.A.C.
• Kathryn Brigitte Fassnacht, CPNP
• Linda Marie Fasullo, M.S. CCC/SLP
• Tara Elizabeth Fay, M.A., CCC-SLP
• Nicholas Fazio, MD
• Stefanie Claire Fedun, M.S. CCC-SLP, TSSLD
• Edward Feldman, LCSW
• Elissa Feldman, R.D.,C.D.N.,C.D.E

• Adult Health Nurse Practitioner in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.