Active NPI
Medinah Faldon, MD
- Internal Medicine Physician
- Fayetteville, GA
National Provider Identifier
1881871663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 057310
- Practice address
- 101 Beckett LN
Suite # 506
Fayetteville, GA 30214-7155 - Phone
- (678) 817-9255
- Fax
- (678) 817-9295
- NPI assigned
- Jan 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 057310 | GA | Primary |
Addresses
Primary practice location
101 Beckett LN
Suite # 506
Fayetteville, GA 30214-7155
Mailing address
PO Box 161739
Atlanta, GA 30321-1739
Phone (678) 817-9255
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 057310 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355097600000",
"number": "1881871663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 161739",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303211739",
"telephone_number": "678-817-9255",
"fax_number": "678-817-9295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BECKETT LN",
"address_2": "SUITE # 506",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302147155",
"telephone_number": "678-817-9255",
"fax_number": "678-817-9295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALDON",
"first_name": "MEDINAH",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2012-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "057310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.