Active Motion Spine & Rehab LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ACTIVE MOTION SPINE & REHAB LLC

Doing business as

Active Motion Spine & Rehab

Practice address

1304 NW Civic Dr
Gresham, OR 97030-5569

Phone

(503) 512-1040

Fax

(503) 662-7334

NPI assigned

Sep 25, 2019

Last updated

Sep 25, 2019By 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. Aaron Montgomery, DCNPI 1528384625

Title

Owner/Clinic Director

Phone

(503) 512-1040

Specialties & licenses 1

Addresses

Other names 1

• Active Motion Spine & Rehab Doing business as

Locations

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.

• Aaron Montgomery, D.C.

  • Chiropractor
  • Gresham, OR
  • NPI 1528384625
  Authorized official Same address or phone

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1164073631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 NW CIVIC DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305569",
            "telephone_number": "503-512-1040",
            "fax_number": "503-662-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 NW CIVIC DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305569",
            "telephone_number": "503-512-1040",
            "fax_number": "503-662-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MOTION SPINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER/CLINIC DIRECTOR",
        "authorized_official_telephone_number": "503-512-1040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Motion Spine & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Gresham, OR
• Providers in Gresham, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.