Fundamental Health and Community Development Services

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

FUNDAMENTAL HEALTH AND COMMUNITY DEVELOPMENT SERVICES

Practice address

1840 W. 5TH St
Dayton, OH 45417

Phone

(937) 469-8524

Fax

(937) 637-2035

NPI assigned

Dec 7, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Mondora F Tingle, RN

Title

Executive Director

Phone

(937) 469-8524

Specialties & licenses 4

Addresses

Other names 1

• Fundamental Health Solutions Inc. Former legal business name

Locations

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1881997260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 W. 5TH ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45417",
            "telephone_number": "937-469-8524",
            "fax_number": "937-637-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 W. 5TH ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45417",
            "telephone_number": "937-469-8524",
            "fax_number": "937-637-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTAL HEALTH AND COMMUNITY DEVELOPMENT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "TINGLE",
        "authorized_official_first_name": "MONDORA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "937-469-8524",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fundamental Health Solutions Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.