NPIMap

Organization Active NPI

Dr. Armen B. Agacanyan DC Chiropractic Corporation

Doing business as Active Spinal & Sports Care, Inc.

  • Chiropractor
  • Morgan Hill, CA
National Provider Identifier
1740480615
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC29204 Issued in CA
Legal business name
DR. ARMEN B. AGACANYAN DC CHIROPRACTIC CORPORATION
Doing business as
Active Spinal & Sports Care, Inc.
Practice address
18525 Sutter Blvd Ste 200
Morgan Hill, CA 95037-2899
Phone
(408) 779-3565
Fax
(408) 779-9810
NPI assigned
Jul 19, 2007
Last updated
Oct 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
Dr. Armen Agacanyan, DCNPI 1902850100
Title
President
Phone
(408) 779-3565

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC29204 CA Primary

Addresses

Primary practice location

18525 Sutter Blvd Ste 200
Morgan Hill, CA 95037-2899

Mailing address

18525 Sutter Blvd Ste 200
Morgan Hill, CA 95037-2899
Phone (408) 779-3565

Other names 1

  • Active Spinal & Sports Care, Inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171130000487 CA Part B Supplier - Clinic/Group Practice 3971860917 Receives reassigned benefits from 4 practitioners
Practice locations: Morgan Hill, CA

National Provider Directory

National Provider Directory

Locations

18525 Sutter Blvd
Ste 200
Morgan Hill, CA 95037
Phone (408) 421-0267

88 W 2nd St
Morgan Hill, CA 95037
Phone (408) 500-2480

Practitioners & affiliated clinicians

Practitioners 4

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": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1740480615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18525 SUTTER BLVD STE 200",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950372899",
            "telephone_number": "408-779-3565",
            "fax_number": "408-779-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18525 SUTTER BLVD STE 200",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950372899",
            "telephone_number": "408-779-3565",
            "fax_number": "408-779-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ARMEN B. AGACANYAN DC CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2023-10-09",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "AGACANYAN",
        "authorized_official_first_name": "ARMEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-779-3565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Spinal & Sports Care, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Morgan Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.