NPIMap

Organization Active NPI

Spectrum Functional Medicine LLC

  • Physical Therapy Clinic/Center
  • Dorchester, MA
National Provider Identifier
1922675370
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPECTRUM FUNCTIONAL MEDICINE LLC
Practice address
28 Edison GRN Apt 2
Dorchester, MA 02125-4783
Phone
(802) 318-1744
NPI assigned
Jun 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Ryan Lunny, PT, DPTNPI 1518412634
Title
Owner
Phone
(802) 318-1744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

28 Edison GRN Apt 2
Dorchester, MA 02125-4783

Mailing address

28 Edison GRN Apt 2
Dorchester, MA 02125-4783
Phone (802) 318-1744

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1922675370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 EDISON GRN APT 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021254783",
            "telephone_number": "802-318-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 EDISON GRN APT 2",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021254783",
            "telephone_number": "802-318-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM FUNCTIONAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "LUNNY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-318-1744",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • 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.