JAMES M FUENDELING, PHD & ASSOCIATES - NPI NUMBER 1992850606

Summary

Provider Name: JAMES M FUENDELING, PHD & ASSOCIATES

NPI Number: 1992850606

Clasification: Psychologist (103TC0700X)

Specialization: Clinical

Address:
840 N POLLARD AVE
FAYETTEVILLE, AR
ZIP 72701

Phone Number: (479) 422-4489



Detailed Information

JAMES M FUENDELING, PHD & ASSOCIATES is a clinical psychologist in Fayetteville, AR. The assigned NPI number for this provider is 1992850606 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

840 N POLLARD AVE
FAYETTEVILLE, AR
ZIP 72701
Phone: (479) 422-4489
Fax: (479) 444-6770

The provider's authorized official is James M Fuendeling .
The authorized official title is Office Manager and has the following contact phone number (479) 422-4489.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 9/20/2012.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1043365620 DR. JANISSA D JACKSON, PHD
Psychologist (Clinical)
1124199906 DR. BARBARA LYNN BROWN, PHD CLINICAL PSYCHOL
Psychologist
1083672299 DR. THOMAS T. LAWSON, PH.D
Psychologist (Clinical)
1114073459 PARKER PSYCHOLOGY & COUNSELING ASSOCIATES
Psychologist (Clinical)
1124152012 DR. ROSALYN D DAVIS, PHD
Psychologist (Counseling)
1134361546 ELIZABETH E KNOWLES, PH.D., PA
Psychologist (Clinical)
1154579902 LESLIE A BLANCHARD, PH.D.
Psychologist (Clinical)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 103TC0700X Psychologist Clinical 01-15P AR No
2 103TC1900X Psychologist Counseling 01-05P AR No
3 103G00000X Clinical Neuropsychologist 01-15P AR Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 BLUECROSS BLUESHIELD OTHER AR 5X899

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1992850606 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name JAMES M FUENDELING, PHD & ASSOCIATES The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 840 N POLLARD AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name FAYETTEVILLE The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name AR The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 72701 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 4794224489 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 4794446770 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 1/24/2007 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 9/20/2012 The date that a record was last updated or changed.
14 Authorized Official Last Name FUENDELING The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name JAMES The first name of the authorized official.
16 Authorized Official Middle Name M The middle name of the authorized official.
17 Authorized Official Title or Position OFFICE MANAGER The title or position of the authorized official.
18 Authorized Official Telephone Number 4794224489 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 103TC0700X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Provider License Number 1 01-15P The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Provider License Number State Code 1 AR The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 103TC1900X
24 Provider License Number 2 01-05P The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
25 Provider License Number State Code 2 AR The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
26 Healthcare Provider Primary Taxonomy Switch 2 N
27 Healthcare Provider Taxonomy Code 3 103G00000X
28 Provider License Number 3 01-15P The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
29 Provider License Number State Code 3 AR The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
30 Healthcare Provider Primary Taxonomy Switch 3 Y
31 Other Provider Identifier 1 BLUECROSS BLUESHIELD Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 1 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier State 1 AR
34 Other Provider Identifier Issuer 1 5X899
35 Is Organization Subpart N
36 Authorized Official Name Prefix Text DR.
37 Authorized Official Credential Text PHD
38 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
39 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP
40 Healthcare Provider Taxonomy Group 3 193200000X MULTI-SPECIALTY GROUP

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.