Fundamentals First Basketball Academy , LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

FUNDAMENTALS FIRST BASKETBALL ACADEMY , LLC

Practice address

977 Eddy Rd.
Cleveland, OH 44108

Phone

(216) 269-1535

NPI assigned

Apr 13, 2020

Last updated

Apr 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wesley Fluellen Sr.NPI 1740761444

Title

Ceo

Phone

(216) 269-1535

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Wesley Fluellen

  • Case Manager/Care Coordinator
  • Cleveland, OH
  • NPI 1740761444
  NPD Authorized official

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1407475080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 EDDY RD.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44108",
            "telephone_number": "216-269-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 EDDY RD.",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44108",
            "telephone_number": "216-269-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTALS FIRST BASKETBALL ACADEMY , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-13",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "FLUELLEN",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-269-1535",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine E. Fultz, CRNA
• Sarah Elizabeth Fultz, MPT
• Fun-to-the-Mental
• Russell Funches, PT
• Fundamentals Adult Day Services, Inc.
• Christina Fundzak, CNP
• Monica T Fundzak, CNP
• Misty Funk, MSSA, LISW
• Perry N. Funk, DO
• Susan Funk, ANP-BC

• Early Intervention Provider Agency in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Early Intervention Provider Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.