Functional Health Institute, Inc

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CH11802FL Issued in FL

Legal business name

FUNCTIONAL HEALTH INSTITUTE, INC

Practice address

132 N Nova Rd
Ormond Beach, FL 32174-5122

Phone

(386) 673-2000

Fax

(386) 673-2002

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Matthew W Fentress, DC

Title

Owner

Phone

(386) 673-2000

Specialties & licenses 1

Addresses

Other names 1

• Advanced Healthcare Physical Medicine, LLC Doing business as

Locations

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1124533856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 N NOVA RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745122",
            "telephone_number": "386-673-2000",
            "fax_number": "386-673-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 N NOVA RD",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745122",
            "telephone_number": "386-673-2000",
            "fax_number": "386-673-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL HEALTH INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "FENTRESS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-673-2000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "CH11802FL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Healthcare Physical Medicine, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Blair Fuller
• Dalia Fulop, MD
• Fulton Sports Medicine LLC
• Brent N Fulton, M.D.
• Funcoast Pediatrics PA
• G. Michael Pilcher, Inc.
• Ashley Gable, PHARMD
• Melissa Miller Gad, ARNP
• Heather Gage, M.D.
• Akilah Gamble

• Neurology Chiropractor in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Neurology Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.