James M Fuendeling, PH.D

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

01-15P Issued in AR

Practice address

2013 N Green Acres Rd
Suite C
Fayetteville, AR 72703-2619

Phone

(479) 422-4489

Fax

(479) 444-6770

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 18, 2015.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1700802485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 N GREEN ACRES RD",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "479-422-4489",
            "fax_number": "479-444-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 N GREEN ACRES RD",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032619",
            "telephone_number": "479-422-4489",
            "fax_number": "479-444-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENDELING",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "01-15P",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AR",
            "license": "01-15P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "5X899",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerald Howard Funkhouser Jr., CRC CSM

• All providers in Fayetteville, AR
• Clinical Neuropsychologist in Arkansas

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