Organization Active NPI

Fly Wheel Center Ga LLC

  • Behavior Analyst
  • Roswell, GA
National Provider Identifier
1396571147
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
FLY WHEEL CENTER GA LLC
Practice address
900 Old Roswell Lakes Pkwy Ste 310
Roswell, GA 30076-8667
Phone
(347) 661-6533
NPI assigned
Sep 10, 2024
Last updated
Sep 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Shraga F Waxman
Title
Owner
Phone
(347) 661-6533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

900 Old Roswell Lakes Pkwy Ste 310
Roswell, GA 30076-8667

Mailing address

174 White St
Lakewood, NJ 08701-4054

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1396571147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 WHITE ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 OLD ROSWELL LAKES PKWY STE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300768667",
            "telephone_number": "347-661-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLY WHEEL CENTER GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "WAXMAN",
        "authorized_official_first_name": "SHRAGA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-661-6533"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.