Austin King Fackler, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Erda, Utah. He graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Tooele Clinic Corp and 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
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and 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 |
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| Experience | 4 Years |
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| Location | 5132 Heidi Way, Erda, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Austin King Fackler graduated from nursing school in 2022
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 |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Tooele Clinic Corp | 6800700873 | 55 |
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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