Organization Active NPI

Fuel the Soul, Inc

  • Rehabilitation Practitioner
  • Merrick, NY
National Provider Identifier
1629661897
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
FUEL THE SOUL, INC
Practice address
188 Merrick Rd
Merrick, NY 11566-4532
Phone
(516) 379-0810
NPI assigned
Feb 18, 2021
Last updated
Feb 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Mr. Gregory FineNPI 1548853708
Title
Owner
Phone
(516) 379-0810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

188 Merrick Rd
Merrick, NY 11566-4532

Mailing address

1934 Carroll Ave
Merrick, NY 11566-2625
Phone (516) 459-4942

National Provider Directory

National Provider Directory

Locations

188 Merrick Rd
Merrick, NY 11566
Phone (516) 379-0810

Practitioners & affiliated clinicians

Practitioners 2

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": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1629661897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 CARROLL AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662625",
            "telephone_number": "516-459-4942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664532",
            "telephone_number": "516-379-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUEL THE SOUL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "FINE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-379-0810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.