Functional Stability & Mobility LLC

Primary specialty

Driving and Community Mobility Occupational TherapistTaxonomy code 225XR0403X

Legal business name

FUNCTIONAL STABILITY & MOBILITY LLC

Practice address

2112 Miles St
Copperas Cove, TX 76522-4144

Phone

(254) 290-3333

Fax

(254) 300-9246

NPI assigned

Aug 20, 2020

Organization subpart

No

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

Authorized official

Name

Megan Elizabeth Hutchinson Frazier, OTR

Title

Owner

Phone

(609) 354-8883

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599782400000",
    "number": "1104438076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 MILES ST",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765224144",
            "telephone_number": "254-290-3333",
            "fax_number": "254-300-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 MILES ST",
            "city": "COPPERAS COVE",
            "state": "TX",
            "postal_code": "765224144",
            "telephone_number": "254-290-3333",
            "fax_number": "254-300-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL STABILITY & MOBILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A",
        "authorized_official_last_name": "HUTCHINSON FRAZIER",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-354-8883",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225XR0403X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Driving and Community Mobility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF FILING NUMBER",
            "identifier": "803010081",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "megan@homeanddriving.com",
            "affiliation": "N",
            "endpointDescription": "Owner's work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2112 Miles St",
            "city": "Copperas Cove",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765224144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.