NPIMap

Organization Active NPI

Functional Life Consulting, LLC

  • Rehabilitation Clinic/Center
  • Erie, PA
National Provider Identifier
1598131393
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
FUNCTIONAL LIFE CONSULTING, LLC
Practice address
3302 West Lake Woods
Apartment #126
Erie, PA 16507-3677
Phone
(847) 644-1280
Fax
(847) 440-9000
NPI assigned
Aug 15, 2015
Last updated
Sep 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Authorized official

Name
Mark Howard Cable, MS, OTR/L, CAPSNPI 1659605129
Title
Owner
Phone
(847) 644-1280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU
Rehabilitation Clinic/Center 261QR0400X NU Primary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X NU
Occupational Medicine Clinic/Center 261QX0100X 056010180 IL
Assisted Living Facility 310400000X NU

Addresses

Primary practice location

3302 West Lake Woods
Apartment #126
Erie, PA 16507-3677

Mailing address

3302 West Lake Woods
Apartment #126
Erie, PA 16507-3677
Phone (847) 644-1280

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1439596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1598131393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3302 WEST LAKE WOODS",
            "address_2": "APARTMENT #126",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165073677",
            "telephone_number": "847-644-1280",
            "fax_number": "847-440-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 WEST LAKE WOODS",
            "address_2": "APARTMENT #126",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165073677",
            "telephone_number": "847-644-1280",
            "fax_number": "847-440-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL LIFE CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-15",
        "last_updated": "2021-09-13",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "CABLE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-644-1280",
        "authorized_official_credential": "MS, OTR/L, CAPS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "IL",
            "license": "056010180",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.