NPIMap

Organization Active NPI

Active Integrated Medicine LLC

  • Integrative Medicine Physician
  • Fort Morgan, CO
National Provider Identifier
1174016331
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
ACTIVE INTEGRATED MEDICINE LLC
Practice address
220 E Beaver Ave
Fort Morgan, CO 80701-3103
Phone
(970) 441-1117
NPI assigned
Jun 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Leif Allen Stephens, DCNPI 1770733297
Title
Owner
Phone
(970) 458-5216

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Integrative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202D00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

220 E Beaver Ave
Fort Morgan, CO 80701-3103

Mailing address

220 E Beaver Ave
Fort Morgan, CO 80701-3103
Phone (970) 441-1117

Other identifiers 2

IdentifierTypeStateIssuer
1679771414MedicaidCO
1679771414OtherCONPI

Other names 2

  • Active Integrated Medicine Doing business as
  • Proactive Medicine LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190313000291 CO Part B Supplier - Clinic/Group Practice 4688914526 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Morgan, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1174016331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E BEAVER AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013103",
            "telephone_number": "970-441-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E BEAVER AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013103",
            "telephone_number": "970-441-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE INTEGRATED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "LEIF",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-458-5216",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679771414",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679771414",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Integrated Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive Medicine LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Morgan, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare 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.