NPIMap

Organization Active NPI

Active Physical Therapy & Sports Injury Center, LLC

  • Physical Therapist
  • Missoula, MT
National Provider Identifier
1316949340
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1758PT Issued in MT
Legal business name
ACTIVE PHYSICAL THERAPY & SPORTS INJURY CENTER, LLC
Practice address
1410 S Reserve St
Missoula, MT 59801-4701
Phone
(406) 829-9600
Fax
(406) 829-9602
NPI assigned
Aug 10, 2005
Last updated
Oct 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Dr. Timothy J Messer, DPTNPI 1275687683
Title
Owner
Phone
(406) 829-9600

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 1758PT MT Primary

Addresses

Primary practice location

1410 S Reserve St
Missoula, MT 59801-4701

Mailing address

1410 S Reserve St
Missoula, MT 59801-4701
Phone (406) 829-9600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060119000799 MT Part B Supplier - Clinic/Group Practice 5799709523 Receives reassigned benefits from 6 practitioners
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

1410 S Reserve St
Missoula, MT 59801
Phone (406) 327-0234

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": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1316949340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S RESERVE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014701",
            "telephone_number": "406-829-9600",
            "fax_number": "406-829-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S RESERVE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014701",
            "telephone_number": "406-829-9600",
            "fax_number": "406-829-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE PHYSICAL THERAPY & SPORTS INJURY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "MESSER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-829-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1758PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2012; 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.