Organization Active NPI

Ultramed Group, Inc

Doing business as Active Lifestyle Medical

  • General Practice Physician
  • Sterling, VA
National Provider Identifier
1376076059
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ULTRAMED GROUP, INC
Doing business as
Active Lifestyle Medical
Practice address
20 Pidgeon Hill Dr
Suite 102
Sterling, VA 20165-6154
Phone
(703) 444-4141
NPI assigned
Apr 10, 2017
Last updated
Jan 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Charles N Arndt, DCNPI 1558556126
Title
Owner
Phone
(703) 444-4141

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
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

20 Pidgeon Hill Dr
Suite 102
Sterling, VA 20165-6154

Mailing address

20 Pidgeon Hill Dr
Suite 102
Sterling, VA 20165-6154
Phone (703) 444-4141

Other names 1

  • Active Lifestyle Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200331002844 VA Part B Supplier - Clinic/Group Practice 6204265978 Receives reassigned benefits from 1 practitioner
Practice locations: Sterling, VA

National Provider Directory

National Provider Directory

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": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1376076059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PIDGEON HILL DR",
            "address_2": "SUITE 102",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656154",
            "telephone_number": "703-444-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PIDGEON HILL DR",
            "address_2": "SUITE 102",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656154",
            "telephone_number": "703-444-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTRAMED GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "ARNDT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-444-4141",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Lifestyle Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.