Austin King Fackler, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Erda, Utah. His current practice location is
5132 Heidi Way, Erda, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 773-8173.
Austin King Fackler is licensed to practice in Utah (license number 11081203-4405) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1437871514.
Provider's Profile
| Full Name | Austin King Fackler |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 5132 Heidi Way, Erda, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1437871514
- Provider Enumeration Date: 09/14/2022
- Last Update Date: 09/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 3072982578
- Enrollment ID: I20221205002547
Medical Identifiers
Medical identifiers for Austin King Fackler such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1437871514 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 11081203-4405 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Austin King Fackler allows following entities to bill medicare on his behalf.
| Entity Name | Tooele Clinic Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073512364
PECOS PAC ID: 6800700873
Enrollment ID: O20031113000800 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Austin King Fackler is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Austin King Fackler, FNP-C
5132 Heidi Way,
Erda, UT 84074-9246
Ph: (435) 773-8173 | Austin King Fackler, FNP-C
5132 Heidi Way,
Erda, UT 84074-9246
Ph: (435) 773-8173 |
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