Russell Funches, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 012482 Issued in OH

Practice address

5908 Linwood Ave
Cleveland, OH 44103-3012

Phone

(216) 326-7487

NPI assigned

Dec 18, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1609297688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 E 73RD ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441034827",
            "telephone_number": "216-326-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 LINWOOD AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033012",
            "telephone_number": "216-326-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNCHES",
        "first_name": "RUSSELL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-18",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT012482",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT 012482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nicole Fulton
• Scott A Fulton, MD
• Christine E. Fultz, CRNA
• Sarah Elizabeth Fultz, MPT
• Fun-to-the-Mental
• Fundamentals Adult Day Services, Inc.
• Fundamentals First Basketball Academy , LLC
• Christina Fundzak, CNP
• Monica T Fundzak, CNP
• Misty Funk, MSSA, LISW

• Physical Therapist in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.