Shawana Avre Faulk, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005504 Issued in NC

Practice address

522 Owen Dr
Fayetteville, NC 28304-3432

Phone

(866) 389-2727

Fax

(401) 652-9787

NPI assigned

Feb 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1328313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1801168919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043432",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043432",
            "telephone_number": "866-389-2727",
            "fax_number": "401-652-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "SHAWANA",
        "middle_name": "AVRE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01243890",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005953",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "171PU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fastmed Health NC, PLLC
• Fastmed Primary Care, P.C.
• Emmanuel Toluwani Fasusi
• Sumaira Fatima, MD
• Deja Shania Faulk
• Greggory Faulkner
• Kadesha Tannisha Faulkner
• Sheryl Lorraine Faulknor-Hyman
• Favor Cap Services Inc.
• Favor Cap Services, Inc.

• Family Nurse Practitioner in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.