NPIMap

Organization Active NPI

Active Recovery TMS PLLC

  • Psychiatry Physician
  • Salem, OR
National Provider Identifier
1316752033
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ACTIVE RECOVERY TMS PLLC
Practice address
2525 12TH St SE Ste 210
Salem, OR 97302-2281
Phone
(206) 210-1198
Fax
(503) 914-1401
NPI assigned
Feb 10, 2025
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Amy Dawn Moore
Title
Contractor
Phone
(503) 819-6585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2525 12TH St SE Ste 210
Salem, OR 97302-2281

Mailing address

11850 SW 67TH Ave Ste 105
Portland, OR 97223-8963

National Provider Directory

National Provider Directory
Tax ID family
Active Recovery TMS PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10151 SE Sunnyside Rd
Ste 360
Clackamas, OR 97015
Phone (206) 210-1198

2701 NW Vaughn St
Ste 470
Portland, OR 97210
Phone (503) 832-4861

11850 SW 67th Ave
Ste 130
Tigard, OR 97223
Phone (503) 765-8376

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": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1316752033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 SW 67TH AVE STE 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 12TH ST SE STE 210",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022281",
            "telephone_number": "206-210-1198",
            "fax_number": "503-914-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE RECOVERY TMS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CONTRACTOR",
        "authorized_official_telephone_number": "503-819-6585"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.