NPIMap

Organization Active NPI

Active Healing Center for Wellness, Inc

  • Chiropractor
  • Colts Neck, NJ
National Provider Identifier
1396006318
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00554200 Issued in NJ
Legal business name
ACTIVE HEALING CENTER FOR WELLNESS, INC
Practice address
81 Hwy 34 S
Colts Neck, NJ 07722-1783
Phone
(732) 683-0200
Fax
(732) 683-1004
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Thomas William Gustafson, D.C.
Title
Owner
Phone
(732) 683-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00554200 NJ Primary

Addresses

Primary practice location

81 Hwy 34 S
Colts Neck, NJ 07722-1783

Mailing address

81 Hwy 34 S
Colts Neck, NJ 07722-1783
Phone (732) 683-0200

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1396006318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HWY 34 S",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221783",
            "telephone_number": "732-683-0200",
            "fax_number": "732-683-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HWY 34 S",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221783",
            "telephone_number": "732-683-0200",
            "fax_number": "732-683-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HEALING CENTER FOR WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-683-0200",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00554200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.