Functional Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8490 Issued in AZ

Legal business name

FUNCTIONAL WELLNESS CENTER LLC

Practice address

7555 E Osborn Rd
Ste. 102
Scottsdale, AZ 85251-6434

Phone

(517) 499-8791

NPI assigned

Jul 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Andrew Lee Kellogg, D.C.

Title

Owner

Phone

(517) 499-8791

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1689059479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 E OSBORN RD",
            "address_2": "STE. 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516434",
            "telephone_number": "517-499-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 E OSBORN RD",
            "address_2": "STE. 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516434",
            "telephone_number": "517-499-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "KELLOGG",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-499-8791",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8489",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lalita Devonne Fulson
• William Alexander Fulton, M.D.
• Fultz Therapy
• Elle Kathryn-Forbes Fultz
• Functional Restoration, PLLC
• Maria L Funicello, DC
• Jordyn Funk, D.M.D.
• Taylor Funk
• Luciana Funtowicz, MD
• Katharine Wadsworth Furio, LCSW

• Chiropractor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.