NPIMap

Organization Active NPI

Active Lifestyle Medical PC

  • Clinic/Center
  • Scottsdale, AZ
National Provider Identifier
1013970334
Registry record updated Feb 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
000000000928481 Issued in AZ
Legal business name
ACTIVE LIFESTYLE MEDICAL PC
Practice address
9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099
Phone
(480) 860-0300
Fax
(480) 422-4321
NPI assigned
Apr 8, 2006
Last updated
Feb 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2015

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

Authorized official

Name
Thomas L Tinlin, DC
Title
President Senior Clinician
Phone
(480) 860-0300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 000000000928481 AZ Primary

Addresses

Primary practice location

9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099

Mailing address

9449 N 90TH St
Ste 114
Scottsdale, AZ 85258-5099
Phone (480) 860-0300

National Provider Directory

National Provider Directory

Locations

10117 N 92nd St
Ste 102
Scottsdale, AZ 85258
Phone (480) 860-0300

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423353600000",
    "number": "1013970334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9449 N 90TH ST",
            "address_2": "STE 114",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585099",
            "telephone_number": "480-860-0300",
            "fax_number": "480-422-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9449 N 90TH ST",
            "address_2": "STE 114",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585099",
            "telephone_number": "480-860-0300",
            "fax_number": "480-422-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFESTYLE MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-08",
        "last_updated": "2015-02-08",
        "status": "A",
        "authorized_official_last_name": "TINLIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT SENIOR CLINICIAN",
        "authorized_official_telephone_number": "480-860-0300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "000000000928481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.