Active Sports Physical Therapy PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACTIVE SPORTS PHYSICAL THERAPY PLLC

Practice address

331 W State Highway 6 Ste G
Waco, TX 76710-5584

Phone

(254) 300-1941

Fax

(254) 875-0472

NPI assigned

Mar 5, 2019

Last updated

Jul 5, 2022By 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

Dr. Matthew Shane, PT, DPT

Title

Owner

Phone

(254) 300-1941

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Todd Christina Monsen, PT, DPT

  • Physical Therapist
  • Waco, TX
  • NPI 1114568565
  NPD

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1053879353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 W STATE HIGHWAY 6 STE G",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105584",
            "telephone_number": "254-300-1941",
            "fax_number": "254-875-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W STATE HIGHWAY 6 STE G",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105584",
            "telephone_number": "254-300-1941",
            "fax_number": "254-875-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SPORTS PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "SHANE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-300-1941",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Active Therapy Group LLC
• Charles Thomas Adamo, DDS, MS
• Wendy Adamo, PT, DPT
• Renee Adamonis, LAT, ATC
• Cynthia Stephens Adams

• Physical Therapy Clinic/Center in Waco, TX
• Providers in Waco, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.