Fatsal Spectacle LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

FATSAL SPECTACLE LLC

Practice address

2835 Pointe Bay Rd # 46229
Indianapolis, IN 46229-0003

Phone

(317) 222-0274

NPI assigned

Jul 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Bolaji Salahudeen Imam, MD

Title

Managing Director

Phone

(317) 222-0274

Specialties & licenses 1

Addresses

Other names 1

• FATSAL SPECTACLE LLC Former legal business name

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

{
    "created_epoch": "1720828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720828800000",
    "number": "1760229926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 POINTE BAY RD # 46229",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462290003",
            "telephone_number": "317-222-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 POINTE BAY RD # 46229",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462290003",
            "telephone_number": "317-222-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FATSAL SPECTACLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "IMAM",
        "authorized_official_first_name": "BOLAJI",
        "authorized_official_middle_name": "SALAHUDEEN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "317-222-0274",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FATSAL SPECTACLE LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Deanna Kay Fathauer, PTA
• Hala Fatima, M.D.
• Maham Fatima, MD
• Sumayya Fatima, MD
• Omolayo Ololade Fatola, MD
• Jean Ann Fattic, RN
• Richard Laurel Fattic
• Juliet Fatunbi, PHARMD
• Sean Faughnan, PA-C
• Philip Faught, M.D.

• Personal Care Attendant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Personal Care Attendant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; 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.