Mary Fundaro, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703110598 Issued in MI

Practice address

4345 Crooks Rd
Unit 4
Royal Oak, MI 48073-1971

Phone

(586) 980-1148

NPI assigned

Mar 18, 2014

Last updated

Mar 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1215354071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 CROOKS RD",
            "address_2": "UNIT 4",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731971",
            "telephone_number": "586-980-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 CROOKS RD",
            "address_2": "UNIT 4",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731971",
            "telephone_number": "586-980-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDARO",
        "first_name": "MARY",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-18",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703110598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fulcrum Med Inc.
• Full Circle Health & Wellness
• Brent Fuller
• Joseph Fullmer, MD
• Functional Physical Therapy of Royal Oak
• Victoria Anne Funk, REGISTER
• Michelle Lynn Furmaga, MD
• Gabrielle Furr
• Rachel Lynne Gabriel
• Hannah Gadway, MD

• Licensed Practical Nurse in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.