Fedelis Fondungallah

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

11851 W Kinderman Dr
Avondale, AZ 85323-9115

Phone

(651) 235-3994

NPI assigned

May 19, 2026

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Theresa Fondungallah Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1779148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1679403190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11851 W KINDERMAN DR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853239115",
            "telephone_number": "651-235-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11851 W KINDERMAN DR",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853239115",
            "telephone_number": "651-235-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDUNGALLAH",
        "first_name": "FEDELIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-05-19",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "FONDUNGALLAH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lenissa Flores-Greer
• Brenda Flores
• Dawn Marie Flores, MS, CCC-SLP
• Patricia M Flynn, DC DABCO
• Ed Foltz, PHARMD
• Stephanie Andrea Forgey, L.M.T.
• Rebecca Walters Franklin, RN
• Sasha Franklin
• Christina Noel Frawley
• Erika Frederick, LAC

• Nurse's Aide in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Nurse's Aide in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.