Active Wellness

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ACTIVE WELLNESS

Practice address

6 Coventry CT
Cherry Hill, NJ 08002-1519

Phone

(609) 707-2856

NPI assigned

Nov 9, 2020

Last updated

Nov 9, 2020By 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

Mrs. Nicole Cannon, PTNPI 1942451356

Title

Physical Therapist/Owner

Phone

(609) 707-2856

Specialties & licenses 1

Addresses

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.

• Nicole Margaret Cannon, DPT

  • Physical Therapist
  • Philadelphia, PA
  • NPI 1942451356
  NPD Authorized official

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1528660206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 COVENTRY CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021519",
            "telephone_number": "609-707-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COVENTRY CT",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080021519",
            "telephone_number": "609-707-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "609-707-2856",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Z Abramson, LSW
• Vincent J Acampora, DO
• Acare Home Services LLC
• Accurate Answers
• Randy B Ackerman, MD
• Acu at Cherry Hill LLC
• Fallon A Acuff, MS, CCC-SLP
• Acupuncture & Oriental Health Care, LLC
• Acupuncture Specialists
• Acute Chronic Neurocareassociates LLC

• Physical Therapy Clinic/Center in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Physical Therapy Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.