Organization Active NPI

Active Life Medical, PLLC

Doing business as Arthritis Knee Pain Centers

  • Physical Medicine & Rehabilitation Physician
  • White Plains, NY
National Provider Identifier
1417577479
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ACTIVE LIFE MEDICAL, PLLC
Doing business as
Arthritis Knee Pain Centers
Practice address
311 North St Ste 406
White Plains, NY 10605-2217
Phone
(914) 785-7752
Fax
(914) 363-0966
NPI assigned
Apr 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Dr. John J Rush, MD
Title
Chairman & Chief Executive Officer
Phone
(301) 928-1697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

311 North St Ste 406
White Plains, NY 10605-2217

Mailing address

311 North St Ste 406
White Plains, NY 10605-2217
Phone (914) 785-7752

Other names 1

  • Arthritis Knee Pain Centers Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1587340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1417577479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 406",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052217",
            "telephone_number": "914-785-7752",
            "fax_number": "914-363-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 NORTH ST STE 406",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106052217",
            "telephone_number": "914-785-7752",
            "fax_number": "914-363-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE MEDICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHAIRMAN & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-928-1697",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arthritis Knee Pain Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; 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.