KHANDRA DELL FAULKNER MS, RDN
NPI 1720936883
Dietitian, Registered in Conway, AR

Q: What is Khandra Faulkner's NPI number?

The NPI number for Khandra Faulkner is 1720936883. It was assigned to this individual provider in the NPPES registry on March 16, 2026.

Q: What is Khandra Faulkner's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Khandra Faulkner was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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 March 16, 2026

2200 BRUCE ST, CONWAY, AR 72034(501) 470-7457(501) 450-3296 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Khandra Dell Faulkner Ms, Rdn NPPES

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

KHANDRA DELL FAULKNER MS, RDN (NPI 1720936883) is an individual dietitian, registered in Conway, Arkansas, licensed in Arkansas (899239) and active in the NPI registry since March 2026. She is a graduate of Other (2000).

NPPES Registry Identity

NPI1720936883

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameKHANDRA DELL FAULKNERCredential: MS, RDN

Location Address2200 BRUCE STConway, AR 72034-6108

Mailing AddressNutrition And Family Sciences - Macalister 100, Uca 201 Donaghey AveConway, AR 72035-0001 · (501) 908-9477 · Fax (501) 908-9477

Phone(501) 470-7457

Fax(501) 450-3296

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateMarch 16, 2026

NPPES CertifiedMarch 16, 2026

✔ NPI 1720936883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in AR · 899239

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

2200 BRUCE ST, Conway, AR 72034

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Khandra Dell Faulkner Ms, Rdn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951878750

PECOS Enrollment IDI20260429003049

Medicare Billing Reassignment

Medicare enrollment records show Khandra Faulkner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Central Arkansas

Same address

Speech-Language Pathologist

2200 BRUCE STREET, STE 101
Conway, AR 72034

Reassigned Medicare billing, Arkansas enrollment
13 clinicians in this Medicare group

NPI 1184387540 (501) 470-7457

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

AARON TAYLOR MCLAUGHLIN PHD

Psychologist (Counseling)

2200 BRUCE ST
CONWAY, AR 72034

Faulkner County (501) 470-7457

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Khandra Faulkner's NPI number?

The NPI number for Khandra Faulkner is 1720936883. It was assigned to this individual provider in the NPPES registry on March 16, 2026.

Where is Khandra Faulkner located?

Khandra Faulkner practices at 2200 Bruce St, Conway, AR 72034. The listed phone number is (501) 470-7457.

What is Khandra Faulkner's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Khandra Faulkner enrolled in Medicare?

Yes. Khandra Faulkner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Khandra Faulkner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Khandra Faulkner reassigns Medicare benefits to University Of Central Arkansas (Conway, AR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Khandra Faulkner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Khandra Faulkner was last updated on March 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.