Active NPI
Ronald Faulkner, MD
- Family Medicine Physician
- Radcliff, KY
National Provider Identifier
1891735908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19636
- Practice address
- 650 W Lincoln Trail Blvd
Radcliff, KY 40160-2602 - Phone
- (270) 352-4601
- Fax
- (270) 352-4600
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19636 | KY | Primary |
Addresses
Primary practice location
650 W Lincoln Trail Blvd
Radcliff, KY 40160-2602
Mailing address
650 W Lincoln Trail Blvd
Radcliff, KY 40160-2602
Phone (270) 352-4601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64196363 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19636 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care @ Home, LLC | Family Medicine | Current | Accepting new patients |
| James Moss PLLC | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1891735908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 W LINCOLN TRAIL BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401602602",
"telephone_number": "270-352-4601",
"fax_number": "270-352-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 W LINCOLN TRAIL BLVD",
"city": "RADCLIFF",
"state": "KY",
"postal_code": "401602602",
"telephone_number": "270-352-4601",
"fax_number": "270-352-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAULKNER",
"first_name": "RONALD",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "19636",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64196363",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Radcliff, KY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.