Jacob Wayne Faulkner, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN217024 Issued in GA

Practice address

1035 Red Bud Rd NE
Calhoun, GA 30701-6010

Phone

(706) 602-7800

NPI assigned

Apr 6, 2016

Last updated

Apr 6, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chattanooga Hamilton County Hospital AuthorityGroup PAC ID 0547179731, 159 clinicians

Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chattanooga Hamilton County Hospital Authority

  dba UT Erlanger Health Network

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1154751931
  Medicare reassignment Care Compare group NPD
• Erlanger Health

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1477256303
  Medicare reassignment Care Compare group NPD
• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Calhoun, GA
  • NPI 1205290467
  Medicare reassignment NPD
• En LLC

  dba Erlanger Express Care

  • Urgent Care Clinic/Center
  • Ringgold, GA
  • NPI 1548829187
  Medicare reassignment
• Gordon Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Chatsworth, GA
  • NPI 1639621485
  NPD
• Chattanooga Hamilton County Hospital Authority

  dba Erlanger Bledsoe Swing Bed

  • Medicare Defined Swing Bed Hospital Unit
  • Pikeville, TN
  • NPI 1073622007
  NPD
• Erlanger Health

  • Durable Medical Equipment & Medical Supplies
  • Chattanooga, TN
  • NPI 1740073329
  NPD
• Chattanooga Hamilton County Hospital Authority

  dba Erlanger Medical Center

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1639264575
  NPD (past)

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

• Erlanger Health

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1861194086
  Care Compare affiliation

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1780048785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1344",
            "city": "COLLEGEDALE",
            "state": "TN",
            "postal_code": "373151344",
            "telephone_number": "405-308-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 RED BUD RD NE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307016010",
            "telephone_number": "706-602-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "JACOB",
        "middle_name": "WAYNE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN217024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evernorth Direct Health LLC (Mohawk Healthy Life Center - Sugar Valley)
• Evernorth Direct Health LLC (Mohawk Healthy Life Center - Union Grove)
• Evernorth Direct Health LLC
• Family First Primary Care, LLC
• John C Farris, APC
• Sheretta Vonda Fielder, MA, CCC-SLP
• Amy Fiest, PT
• Brenda Sue Fisher, PA-C
• Floyd Healthcare Management, Inc (Atrium Health Floyd Urgent Care Calhoun)
• Jamie Folds, DC

• Acute Care Nurse Practitioner in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.