Function & Health Professionals LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

58891 Issued in GA

Legal business name

FUNCTION & HEALTH PROFESSIONALS LLC

Practice address

685 Arlington PL
Macon, GA 31201-1772

Phone

(478) 292-2060

NPI assigned

Nov 27, 2015

Organization subpart

No

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

Authorized official

Name

Tiquella Shantel King-Whitby, MD, DABMANPI 1366620957

Title

Ceo

Phone

(404) 449-0545

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tiquella Shantel King-Whitby, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Macon, GA
  • NPI 1366620957
  NPD (past) Authorized official

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

{
    "created_epoch": "1448582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448582400000",
    "number": "1376917591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20731",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312050731",
            "telephone_number": "478-292-2060",
            "fax_number": "877-991-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 ARLINGTON PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011772",
            "telephone_number": "478-292-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTION & HEALTH PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-27",
        "last_updated": "2015-11-27",
        "status": "A",
        "authorized_official_last_name": "KING-WHITBY",
        "authorized_official_first_name": "TIQUELLA",
        "authorized_official_middle_name": "SHANTEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-449-0545",
        "authorized_official_credential": "MD, DABMA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "58891",
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "GA",
            "license": "58891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chevita Edwards Fuller, FNP-BC
• Crystal G Fuller, DDS
• Destiny Fuller, LPN
• Janet P Fuller, CRNA
• Michael F Fuller, MD
• Matthew Fuqua
• Fusion Back and Body Center, LLC
• Futurecare LLC
• G. Clark Stull, DC PC
• Ga Diagnostic Providers LLC

• Medical Specialty Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2015; 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.