Active NPI
Active Therapy Management LLC
- Assisted Living Facility
- Henderson, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- ACTIVE THERAPY MANAGEMENT LLC
- Practice address
- 1905 Old Nacogdoches Rd
Henderson, TX 75654-4630 - Phone
- (903) 657-1563
- NPI assigned
- Sep 29, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ashok Gupta, PT
- Title
- Ceo
- Phone
- (954) 702-3000
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
1905 Old Nacogdoches Rd
Henderson, TX 75654-4630
Mailing address
1918 E Front St
Tyler, TX 75702-8511
Other names 1
- Pine Lodge Assisted Living
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2048678 | Pine Lodge Assisted Living | Certificate of waiver | Oct 21, 2026 |
National Provider Directory
National Provider DirectoryLocations
1918 E Front St
Tyler, TX 75702
Phone (844) 797-0669
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physical Therapist
- Tyler, TX
- NPI 1124464847
-
- Physical Therapist
- Tyler, TX
- NPI 1770064669
-
- Physical Therapist
- Stockbridge, GA
- NPI 1750813416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759104000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759104000000",
"number": "1376416875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1918 E FRONT ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757028511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 OLD NACOGDOCHES RD",
"city": "HENDERSON",
"state": "TX",
"postal_code": "756544630",
"telephone_number": "903-657-1563"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACTIVE THERAPY MANAGEMENT LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-09-29",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A",
"authorized_official_last_name": "GUPTA",
"authorized_official_first_name": "ASHOK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "954-702-3000",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Pine Lodge Assisted Living",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Henderson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.