Fundamentum LLC

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

FUNDAMENTUM LLC

Practice address

5830 E McKellips Rd Unit 49
Mesa, AZ 85215-2784

Phone

(480) 652-6532

NPI assigned

Feb 14, 2024

Organization subpart

No

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

Authorized official

Name

Susan Andazola

Title

Director of Operations

Phone

(480) 450-0847

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1707868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1548025075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 E MCKELLIPS RD UNIT 49",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152784",
            "telephone_number": "480-652-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5830 E MCKELLIPS RD UNIT 49",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152784",
            "telephone_number": "480-652-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTUM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-14",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ANDAZOLA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-450-0847"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas E Fullmer, P.T.
• Nancy Fulmore, AGACNP-BC
• Fulton & Fulton LLC
• Fulton & Wilson
• Troy Michael Fulton
• Arianna Fundora
• Brian Fung, MD
• Yun Fung, NP
• Robert J Furman, M.D.
• Stacy Fusco, MS,CCC-SLP

• Home Health Registered Nurse in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Home Health Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.