Active Spine Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

3643 Issued in NE

Legal business name

ACTIVE SPINE PHYSICAL THERAPY, LLC

Doing business as

Active Physical Therapy

Practice address

10110 Nicholas St Ste 100
Omaha, NE 68114

Phone

(402) 932-2888

Fax

(402) 932-2899

NPI assigned

Oct 7, 2016

Last updated

Dec 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicholas Christopher MuchowiczNPI 1568444784

Title

PT

Phone

(402) 932-2888

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Active Physical Therapy Doing business as

Locations

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.

• Nicholas Christopher Muchowicz, MPT

  • Physical Therapist
  • Omaha, NE
  • NPI 1568444784
  NPD Authorized official
• Abigail Krull, M.S.

  • Speech-Language Pathologist
  • Omaha, NE
  • NPI 1225595937
  NPD (past)
• Bailey A Miller, OT

  • Occupational Therapist
  • Omaha, NE
  • NPI 1316595341
  NPD (past)
• Sara Katherine Smidt, OTR/L, MOT

  • Occupational Therapist
  • Omaha, NE
  • NPI 1578111811
  NPD (past)
• Elizabeth Stiles, ST

  • Speech-Language Pathologist
  • Omaha, NE
  • NPI 1023650371
  NPD (past)
• Elizabeth Ann Deutsch, OT

  • Occupational Therapist
  • Bloomington, IL
  • NPI 1619425394
  NPD (past)

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1023568540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 NICHOLAS ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681142185",
            "telephone_number": "402-932-2888",
            "fax_number": "402-932-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10110 NICHOLAS ST STE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68114",
            "telephone_number": "402-932-2888",
            "fax_number": "402-932-2899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7919 Wakeley Plz",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681143677",
            "country_code": "US",
            "telephone_number": "402-932-2888",
            "fax_number": "402-932-2899",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10110 Nicholas St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "68114",
            "country_code": "US",
            "telephone_number": "402-932-2888",
            "fax_number": "402-932-2899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACTIVE SPINE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "MUCHOWICZ",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "402-932-2888"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NE",
            "license": "3643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3643",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3643",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Active Care Home Health, LLC
• Active Hearing Health
• Active Motion Chiropractic P.C.
• Active Solutions Chiropractic, P.C.
• Active Spine and Joint Chiropractic LLC (Harvest Chiropractic & Wellness)
• Active Spine Physical Therapy, LLC (Active Therapy)
• Diana Acuna
• Adjo Sara Stella Ada
• Henrique Adabo, MD
• Shelby Adair, PTA

• Physical Therapy Clinic/Center in Omaha, NE
• Providers in Omaha, NE by specialty
• Physical Therapy Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.