Functional Restoration, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FUNCTIONAL RESTORATION, PLLC

Doing business as

SportExcel

Practice address

9377 E Bell Rd
Suite 101
Scottsdale, AZ 85260-1502

Phone

(480) 513-4801

Fax

(480) 513-4867

NPI assigned

May 26, 2006

Organization subpart

No

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

Authorized official

Name

Shelley Ann McClellan, DPT

Title

Clinic Director

Phone

(480) 513-4801

Specialties & licenses 1

Addresses

Other names 1

• SportExcel Doing business as

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144276395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9377 E BELL RD",
            "address_2": "SUITE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601502",
            "telephone_number": "480-513-4801",
            "fax_number": "480-513-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9377 E BELL RD",
            "address_2": "SUITE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852601502",
            "telephone_number": "480-513-4801",
            "fax_number": "480-513-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL RESTORATION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLELLAN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "480-513-4801",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SportExcel",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher John Fullmer, PA-C
• Lalita Devonne Fulson
• William Alexander Fulton, M.D.
• Fultz Therapy
• Elle Kathryn-Forbes Fultz
• Functional Wellness Center LLC
• Maria L Funicello, DC
• Jordyn Funk, D.M.D.
• Taylor Funk
• Luciana Funtowicz, MD

• Physical Therapist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.