Organization Active NPI

Activelife Family Chiropractic, P.a.

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1508180506
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9717 Issued in FL
Legal business name
ACTIVELIFE FAMILY CHIROPRACTIC, P.A.
Practice address
1712 Cape Coral Pkwy E
Cape Coral, FL 33904-9620
Phone
(239) 540-5433
Fax
(239) 549-3376
NPI assigned
Mar 19, 2010
Last updated
Mar 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Authorized official

Name
Dr. Michael Phillip Cartales, D.C.NPI 1528150349
Title
President
Phone
(239) 540-5433

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
Chiropractor 111N00000X CH9717 FL Primary

Addresses

Primary practice location

1712 Cape Coral Pkwy E
Cape Coral, FL 33904-9620

Mailing address

1712 Cape Coral Pkwy E
Cape Coral, FL 33904-9620
Phone (239) 540-5433

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100512000920 FL Part B Supplier - Clinic/Group Practice 9335277334 Receives reassigned benefits from 1 practitioner
Practice locations: Cape Coral, FL

National Provider Directory

National Provider Directory

Locations

1712 Cape Coral Pkwy E
Cape Coral, FL 33904
Phone (239) 540-5433

Practitioners & affiliated clinicians

Practitioners 1

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": "1268956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268956800000",
    "number": "1508180506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049620",
            "telephone_number": "239-540-5433",
            "fax_number": "239-549-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049620",
            "telephone_number": "239-540-5433",
            "fax_number": "239-549-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVELIFE FAMILY CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A",
        "authorized_official_last_name": "CARTALES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-540-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.