Provider Type Icon

JOHNNIE WAYNE FAIRCLOTH M.D. NPI 1912168600


NPI Information

NPI: 1912168600
Provider Name: JOHNNIE WAYNE FAIRCLOTH, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1400 S COULTER ST
AMARILLO, TX
ZIP 79106
Phone: (806) 414-9800
Get Directions

Johnnie Wayne Faircloth, M.D. is a pediatrics in Amarillo, TX. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Johnnie Wayne Faircloth, M.D. NPI is 1912168600. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1400 S COULTER ST
AMARILLO, TX
ZIP 79106-786
Phone: (806) 414-9800
Fax: (806) 354-5689

The NPI 1912168600 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/24/2008 and was last updated on 7/18/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080S0010XPediatricsSports MedicineN7537TEXASNo
2208000000XPediatricsN7537TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
167474560MEDICAIDNEW MEXICO
2291284YPT8MEDICARE PINTEXAS
3280457704MEDICAIDTEXAS
4280457702MEDICAIDTEXAS
5200340500 AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.