Active Innovations

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE INNOVATIONS

Doing business as

KeyMed

Practice address

1892 Bellair Blvd
Orange Park, FL 32073-4548

Phone

(904) 541-0207

Fax

(904) 269-8373

NPI assigned

Nov 19, 2007

Last updated

Nov 19, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bryan K Jacobs

Title

Owner/President

Phone

(904) 541-0207

Specialties & licenses 1

Addresses

Other names 1

• KeyMed Doing business as

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195430400000",
    "number": "1467633495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 BELLAIR BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734548",
            "telephone_number": "904-541-0207",
            "fax_number": "904-269-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1892 BELLAIR BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734548",
            "telephone_number": "904-541-0207",
            "fax_number": "904-269-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE INNOVATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "904-541-0207",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KeyMed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2007; 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.