Active Health Chiropractic LLC
Organization Active NPI Chiropractor · Germantown, TN
NPI 1255670949 · NPPES record last updated Jan 31, 2013
Key facts
- NPI
- 1255670949
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2075 (TN)
- Legal business name
- ACTIVE HEALTH CHIROPRACTIC LLC
- Practice address
- 7844 Farmington Blvd
Germantown, TN 38138-2904 - Phone
- (901) 340-1837
- NPI assigned
- Jan 31, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeremy Layne Jessop, DC
- Title
- Owner/Member
- Phone
- (901) 340-1837
Practitioners 3
-
Jeremy Layne Jessop, D.C.
-
Larry T Davis, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130424000391 | TN | Part B Supplier - Clinic/Group Practice | 9739325531 |
Receives reassigned benefits from 2 practitioners Practice locations: Germantown, TN |
National Provider Directory
Locations
7844 Farmington Blvd
Germantown, TN 38138
Phone (901) 340-1837
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2075 | TN | Yes |
Addresses
Primary practice location
7844 Farmington Blvd
Germantown, TN 38138-2904
Mailing address
7844 Farmington Blvd
Germantown, TN 38138-2904
Phone (901) 340-1837
Other providers in Germantown, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2013. 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.