Organization Active NPI

Active Alliance Physical Therapy LLC

  • Physical Therapist
  • Greenville, SC
National Provider Identifier
1295467389
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVE ALLIANCE PHYSICAL THERAPY LLC
Practice address
355 Woodruff Rd Ste 203
Greenville, SC 29607-3494
Phone
(864) 354-8005
Fax
(864) 712-9270
NPI assigned
Jun 27, 2022
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Dr. Grant Allen Banks, DPTNPI 1053702019
Title
Owner
Phone
(864) 237-1092

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
Physical Therapist 225100000X Primary

Addresses

Primary practice location

355 Woodruff Rd Ste 203
Greenville, SC 29607-3494

Mailing address

355 Woodruff Rd Ste 203
Greenville, SC 29607-3494
Phone (864) 354-8005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231013000234 SC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6709231533 Receives reassigned benefits from 3 practitioners
Practice locations: Greenville, SC

National Provider Directory

National Provider Directory

Locations

355 Woodruff Rd
Ste 203
Greenville, SC 29607
Phone (864) 354-8005

Practitioners & affiliated clinicians

Practitioners 3

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": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1295467389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 WOODRUFF RD STE 203",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073494",
            "telephone_number": "864-354-8005",
            "fax_number": "864-712-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 WOODRUFF RD STE 203",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073494",
            "telephone_number": "864-354-8005",
            "fax_number": "864-712-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE ALLIANCE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-237-1092",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.