Organization Active NPI

Fly Wheel Centers 8400 LLC

  • Behavior Analyst
  • Minneapolis, MN
National Provider Identifier
1083429815
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FLY WHEEL CENTERS 8400 LLC
Practice address
8400 Normandale Lake Blvd
Minneapolis, MN 55437-1085
Phone
(347) 661-6533
NPI assigned
Feb 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Shraga F Waxman
Title
Ceo
Phone
(347) 661-6533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

8400 Normandale Lake Blvd
Minneapolis, MN 55437-1085

Mailing address

174 White St
Lakewood, NJ 08701-4054
Phone (347) 661-6533

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1083429815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 WHITE ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014054",
            "telephone_number": "347-661-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 NORMANDALE LAKE BLVD",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554371085",
            "telephone_number": "347-661-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLY WHEEL CENTERS 8400 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "WAXMAN",
        "authorized_official_first_name": "SHRAGA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-661-6533"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.