Active Spine and Joint Chiropractic LLC

Key facts

NPI: 1164934162
Entity type: Organization (NPI type 2)
Primary specialty: Chiropractor 111N00000X
License: 1904 (NE)
Legal business name: ACTIVE SPINE AND JOINT CHIROPRACTIC LLC
Practice address: 10208 S 168TH Ave Ste 4
Omaha, NE 68136-4185
Phone: (402) 885-9296
NPI assigned: Oct 30, 2017
Organization subpart: No

Authorized official

Name: James Dalton, DC NPI 1457720740
Title: Owner
Phone: (402) 885-9296

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

James Dalton, DC Chiropractor · Omaha, NE · NPI 1457720740

Medicare reassignment Care Compare group NPD Authorized official CHIROPRACTOR · NE
Tracey Dalton, D.C. Chiropractor · Lincoln, NE · NPI 1508239815

Medicare reassignment Care Compare group NPD CHIROPRACTOR · NE

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NE

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20171130002873	NE	Part B Supplier - Clinic/Group Practice	7618234592	Receives reassigned benefits from 2 practitioners Practice locations: Omaha, NE

National Provider Directory

Locations

8301 Cody Dr
Ste Ef
Lincoln, NE 68512
Phone (402) 885-9293

10208 S 168th Ave
Ste 4
Omaha, NE 68136
Phone (402) 853-3867

9819 S 168th Ave
Ste 6C
Omaha, NE 68136
Phone (402) 885-9296

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor Group: 193400000X SINGLE SPECIALTY GROUP	111N00000X	1904	NE	Yes

Addresses

Primary practice location

10208 S 168TH Ave Ste 4
Omaha, NE 68136-4185

Mailing address

215 N 8TH St
Springfield, NE 68059-5743

Other practice location 1

180 Main St
Springfield, NE 68059
Phone (402) 885-9296

Other practice location 2

8301 Cody Dr Ste E&f
Lincoln, NE 68512-3759
Phone (402) 885-9293

Other names

Harvest Chiropractic & Wellness Doing business as
Sarpy Spine and Sport Chiropractic Other name

Other providers in Omaha, NE

All providers in Omaha, NE · Chiropractor in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.