JACOB FAULTERSACK MD
NPI 1427792290
Student in an Organized Health Care Education/Training Program in Chapel Hill, NC

Q: What is Jacob Faultersack's NPI number?

The NPI number for Jacob Faultersack is 1427792290. It was assigned to this individual provider in the NPPES registry on April 26, 2022.

Q: What is Jacob Faultersack's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Jacob Faultersack was last updated on April 26, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 26, 2022PECOS Enrolled

6013 FARRINGTON RD STE 301, CHAPEL HILL, NC 27517(984) 974-6669(984) 974-9609 Get Directions Write a Review

NPPES record last updated: April 26, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Jacob Faultersack Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB FAULTERSACK MD (NPI 1427792290) is an individual student in an organized health care education/training program in Chapel Hill, North Carolina and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427792290

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameJACOB FAULTERSACKCredential: MD

Location Address6013 FARRINGTON RD STE 301Chapel Hill, NC 27517-8173

Mailing Address230 Macnider Hall Campus Box 7593Chapel Hill, NC 27599-7593 · (919) 966-3172 · Fax (919) 966-8419

Phone(984) 974-6669

Fax(984) 974-9609

Sole ProprietorNo

Enumeration DateApril 26, 2022

NPPES CertifiedApril 26, 2022

✔ NPI 1427792290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6013 FARRINGTON RD STE 301, Chapel Hill, NC 27517

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacob Faultersack Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE EMILY BETTI DO

Student in an Organized Health Care Education/Training Program