NPIMap

Organization Active NPI

Active Back Pain Relief Center LLC

  • Chiropractor
  • West Springfield, MA
National Provider Identifier
1063558849
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1917 Issued in MA
Legal business name
ACTIVE BACK PAIN RELIEF CENTER LLC
Practice address
82 Main Street
Suite 8
West Springfield, MA 01089
Phone
(413) 737-7787
Fax
(413) 737-7789
NPI assigned
Jan 29, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Christopher E Johnsen, DCNPI 1134325657
Title
Member
Phone
(413) 737-7787

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
Chiropractor 111N00000X 1917 MA Primary

Addresses

Primary practice location

82 Main Street
Suite 8
West Springfield, MA 01089

Mailing address

82 Main Street
Suite 8
West Springfield, MA 01089
Phone (413) 737-7787

Other identifiers 1

IdentifierTypeStateIssuer
Y39217OtherMABLUE CROSS BLUE SHIELD

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, 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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063558849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 MAIN STREET",
            "address_2": "SUITE 8",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-737-7787",
            "fax_number": "413-737-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAIN STREET",
            "address_2": "SUITE 8",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "01089",
            "telephone_number": "413-737-7787",
            "fax_number": "413-737-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE BACK PAIN RELIEF CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "413-737-7787",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "1917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y39217",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.