Fuse Health & Wellness, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

FUSE HEALTH & WELLNESS, LLC

Practice address

4A College PLZ Ste B
Statesboro, GA 30458-4928

Phone

(912) 531-1225

NPI assigned

Aug 6, 2019

Last updated

Aug 6, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brandon Blair

Title

Ceo

Phone

(912) 531-1225

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1093360182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4A COLLEGE PLZ STE B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584928",
            "telephone_number": "912-531-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4A COLLEGE PLZ STE B",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584928",
            "telephone_number": "912-531-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSE HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-531-1225"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "www.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "CLOUD",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Paper files",
            "address_1": "4A College Plz Ste B",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304584928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fresh Start Counseling Services
• Frontline Internal Medicine LLC
• Mai Fujimoto
• Courtney Fuller, PMHNP-BC
• Jordan Grace Fuller
• Shannon Kay Salter Fussell, PH.D.
• Wendy Futch, NP
• Howard M Gale, DPM
• Merry Gallagher, PHD
• Kacey Gammon, LPC

• Registered Dietitian in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.