Active Medical LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

ACTIVE MEDICAL LLC

Practice address

120 Prosperous PL Ste 103
Lexington, KY 40509-1866

Phone

(859) 421-1195

Fax

(855) 859-0123

NPI assigned

Mar 12, 2018

Last updated

May 25, 2021By 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

Joshua Hill, DPM

Title

Owner

Phone

(859) 421-1195

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Josh Hill DPM LLC Former legal business name

Locations

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621900800000",
    "number": "1750884292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PROSPEROUS PL STE 103",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091866",
            "telephone_number": "859-421-1195",
            "fax_number": "855-859-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PROSPEROUS PL STE 103",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091866",
            "telephone_number": "859-421-1195",
            "fax_number": "855-859-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "859-421-1195",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300040776",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100632930",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Josh Hill DPM LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Providers in Lexington, KY by specialty
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.