Fundamental Health, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

FUNDAMENTAL HEALTH, PLLC

Practice address

725 S Adams Rd Ste 266
Birmingham, MI 48009-6999

Phone

(248) 252-2829

NPI assigned

Nov 18, 2019

Organization subpart

No

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

Authorized official

Name

Marisa ClaysenNPI 1457752974

Title

PA-C

Phone

(248) 252-2829

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marisa Karcz Claysen, PA-C

  • Physician Assistant
  • Birmingham, MI
  • NPI 1457752974
  NPD Authorized official

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574035200000",
    "number": "1699310300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 BOWERS ST",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096886",
            "telephone_number": "248-252-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S ADAMS RD STE 266",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096999",
            "telephone_number": "248-252-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2019-11-18",
        "status": "A",
        "authorized_official_last_name": "CLAYSEN",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "248-252-2829"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@marisa-pac.com",
            "affiliation": "N",
            "endpointDescription": "Practice Address",
            "address_1": "725 S Adams Rd Ste 266",
            "city": "Birmingham",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480096999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Barbara McGough Friedman, MSW
• Howard Philip Friedman, M.D.
• Sonya E Friedman, PH.D.
• Amyna Ftouni
• Functional Fitness L L C
• Peter R Furicchia, MD
• Katherine Elinor Furtaw
• G. Colombini Counseling, PLLC
• Donald J Garfield, D.P.M.
• Elle G Garfield, LMSW, ACSW

• Physician Assistant in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2019; 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.