Organization Active NPI

Active Health Chiropractic LLC

  • Health Service Clinic/Center
  • Delafield, WI
National Provider Identifier
1215325782
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
5057-12 Issued in WI
Legal business name
ACTIVE HEALTH CHIROPRACTIC LLC
Practice address
19 Crossroads CT
Delafield, WI 53018-2066
Phone
(262) 646-2640
Fax
(262) 646-2650
NPI assigned
Jan 6, 2015
Last updated
Jan 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Authorized official

Name
Benjamin C Anderson, D.C.
Title
Doctor/Member
Phone
(262) 646-2640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 5057-12 WI Primary

Addresses

Primary practice location

19 Crossroads CT
Delafield, WI 53018-2066

Mailing address

19 Crossroads CT
Delafield, WI 53018-2066
Phone (262) 646-2640

National Provider Directory

National Provider Directory

Locations

19 Crossroads Ct
Delafield, WI 53018
Phone (262) 646-2640

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": "1420502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1215325782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CROSSROADS CT",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182066",
            "telephone_number": "262-646-2640",
            "fax_number": "262-646-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 CROSSROADS CT",
            "city": "DELAFIELD",
            "state": "WI",
            "postal_code": "530182066",
            "telephone_number": "262-646-2640",
            "fax_number": "262-646-2650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HEALTH CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-06",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR/MEMBER",
        "authorized_official_telephone_number": "262-646-2640",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WI",
            "license": "5057-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delafield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.