NPIMap

Organization Active NPI

Active Life Health of Alpharetta LLC

Doing business as Arthritis Knee Pain Centers

  • Durable Medical Equipment & Medical Supplies
  • Alpharetta, GA
National Provider Identifier
1265101596
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ACTIVE LIFE HEALTH OF ALPHARETTA LLC
Doing business as
Arthritis Knee Pain Centers
Practice address
4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478
Phone
(770) 755-1771
Fax
(770) 370-8140
NPI assigned
Sep 9, 2021
Last updated
Feb 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
John J Rush, MDNPI 1851337281
Title
Chairman & Chief Executive Officer
Phone
(770) 755-1771

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478

Mailing address

4165 Old Milton Pkwy Ste 200
Alpharetta, GA 30005-4478
Phone (770) 755-1771

Other names 1

  • ARTHRITIS KNEE PAIN CENTERS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220624002057 GA DME Supplier - Physician - General Practice 4880082817 Practice locations: Alpharetta, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1265101596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 OLD MILTON PKWY STE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054478",
            "telephone_number": "770-755-1771",
            "fax_number": "770-370-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 OLD MILTON PKWY STE 200",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054478",
            "telephone_number": "770-755-1771",
            "fax_number": "770-370-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE HEALTH OF ALPHARETTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHAIRMAN & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-755-1771",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARTHRITIS KNEE PAIN CENTERS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ARTHRITIS KNEE PAIN CENTERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.