Functional Movement LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

FUNCTIONAL MOVEMENT LLC

Practice address

124 Stadium CT
Ponte Vedra Beach, FL 32082-3152

Phone

(757) 651-0183

NPI assigned

Oct 15, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristen Galloway, OTR/L

Title

Owner

Phone

(757) 651-0183

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571097600000",
    "number": "1083256747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 STADIUM CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823152",
            "telephone_number": "757-651-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 STADIUM CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823152",
            "telephone_number": "757-651-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL MOVEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-651-0183",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicki Fong, MSN, FNP-BC
• Megan Taylor Forgacs
• Erin Fortier, PA-C
• Gabriela Elena Fratila, ARNP
• Ginger Frazier
• Brittany P Fussell
• Melissa Gagliardi, ARNP
• Chelsey Gallegos
• Kristen Galloway
• Susan Gambardella

• Occupational Therapist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.