Kim T Faulkner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME129850 Issued in FL

Practice address

1344 22ND St S
St Petersburg, FL 33712-2744

Phone

(727) 824-8181

Fax

(727) 824-8150

NPI assigned

Jan 4, 2007

Last updated

Jul 21, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center of Pinellas IncGroup PAC ID 8527961028, 65 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Community Health Center of Pinellas Inc

  dba Evara Health

  • Federally Qualified Health Center (FQHC)
  • Clearwater, FL
  • NPI 1467873315

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Community Health Centers of Pinellas Inc.

  dba Evara Health

  • Pharmacy
  • Clearwater, FL
  • NPI 1467273383
  NPD
• Community Health Centers of Pinellas Inc.

  dba Evara Health

  • Federally Qualified Health Center (FQHC)
  • Clearwater, FL
  • NPI 1609586098
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162

  Family Medicine

  NPD (past)
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Eloy, AZ
  • NPI 1588876429
  NPD (past)
• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center-Florence

  • Federally Qualified Health Center (FQHC)
  • Florence, AZ
  • NPI 1902278252
  NPD (past)
• Val Vista Lakes Family Medicine, PC

  • Family Medicine Physician
  • Gilbert, AZ
  • NPI 1487605481
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952458069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10549",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330549",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 22ND ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337122744",
            "telephone_number": "727-824-8181",
            "fax_number": "727-824-8150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "KIM",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME129850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Marie Farris, M.D.
• Danielle N Fasciano, DO
• Avery Jane Fasulo
• Delaram Fatemi, MD
• Barry Faulkner
• Jasmine Favata
• Kelli Anne Faville, DPT
• Tarek Ali Fawaz Jr., PHARM D
• Sybil Prewitt Faylo, AU.D.
• Burnes Lynn Feaster III, MD

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.