Mark Elijah Fankhauser, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1110869 Issued in TX

Practice address

4113 Crosspoint Blvd
Edinburg, TX 78539-1803

Phone

(956) 603-1555

Fax

(956) 800-6369

NPI assigned

Jan 30, 2023

Sex

Male

Sole proprietor

Yes

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.

• Valley Diabetes & Endocrinology Comprehensive Center P.L.L.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Edinburg, TX
  • NPI 1376109637

  Single Specialty, TX

  Medicare reassignment NPD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 17, 2023.

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1841906005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 CROSSPOINT BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391803",
            "telephone_number": "956-603-1555",
            "fax_number": "956-800-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 CROSSPOINT BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785391803",
            "telephone_number": "956-603-1555",
            "fax_number": "956-800-6369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1116 E 8th St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Weslaco",
            "state": "TX",
            "postal_code": "785967288",
            "country_code": "US",
            "telephone_number": "956-603-1555",
            "fax_number": "956-800-6369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANKHAUSER",
        "first_name": "MARK",
        "middle_name": "ELIJAH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "934497",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1110869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family First Medical Center
• Family Imaging of South Texas LLC
• Family Life Concepts PLLC
• Family Outreach
• Family-Focused Health Care, L.L.C.
• Bahram Faraji, RD, LD, DR.PH
• Dahud Jamal Farhan, MD
• Lorenzo M Farolan, M.D.
• Sehar Farooq, MD
• Abdul K Farooqui, O.T.

• All providers in Edinburg, TX
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.