NPIMap

Organization Active NPI

Proactive Physical Therapy,LLC

  • Physical Therapist
  • Lewiston, ME
National Provider Identifier
1609164904
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROACTIVE PHYSICAL THERAPY,LLC
Practice address
1190 Lisbon St
Unit 101
Lewiston, ME 04240-5063
Phone
(207) 376-3000
Fax
(207) 376-3003
NPI assigned
Jul 20, 2011
Last updated
Nov 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Authorized official

Name
Michael LachanceNPI 1437238276
Title
Partner
Phone
(207) 376-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1190 Lisbon St
Unit 101
Lewiston, ME 04240-5063

Mailing address

1190 Lisbon St
Unit 101
Lewiston, ME 04240-5063
Phone (207) 376-3000

National Provider Directory

National Provider Directory

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": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1609164904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 LISBON ST",
            "address_2": "UNIT 101",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405063",
            "telephone_number": "207-376-3000",
            "fax_number": "207-376-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 LISBON ST",
            "address_2": "UNIT 101",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405063",
            "telephone_number": "207-376-3000",
            "fax_number": "207-376-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "LACHANCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "207-376-3000"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.