Organization Active NPI

Active Sport & Spine Therapy LLC

  • Chiropractor
  • Little Falls, NJ
National Provider Identifier
1306572755
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACTIVE SPORT & SPINE THERAPY LLC
Practice address
275 Paterson Ave Ste 202
Little Falls, NJ 07424-1658
Phone
(201) 661-1417
Fax
(973) 475-8130
NPI assigned
Jul 28, 2022
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Dr. Prakash Ramani, DCNPI 1700317161
Title
Owner
Phone
(201) 661-1417

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

275 Paterson Ave Ste 202
Little Falls, NJ 07424-1658

Mailing address

275 Paterson Ave Ste 202
Little Falls, NJ 07424-1658
Phone (201) 661-1417

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221017001719 NJ Part B Supplier - Clinic/Group Practice 7012383037 Receives reassigned benefits from 3 practitioners
Practice locations: Little Falls, NJ

National Provider Directory

National Provider Directory

Locations

275 Paterson Ave
Ste 202
West Paterson, NJ 07424
Phone (201) 661-1417

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": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1306572755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 PATERSON AVE STE 202",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241658",
            "telephone_number": "201-661-1417",
            "fax_number": "973-475-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PATERSON AVE STE 202",
            "city": "LITTLE FALLS",
            "state": "NJ",
            "postal_code": "074241658",
            "telephone_number": "201-661-1417",
            "fax_number": "973-475-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE SPORT & SPINE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "RAMANI",
        "authorized_official_first_name": "PRAKASH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-661-1417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.