NPIMap

Organization Active NPI

Active Day FL, Inc.

  • Adult Day Care Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1760525430
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
ACTIVE DAY FL, INC.
Doing business as
Active Day of Fort Myers
Practice address
6324 Corporate CT
Fort Myers, FL 33919-3507
Phone
(239) 482-4459
Fax
(239) 482-8396
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kris W. Baldock
Title
Chairman, Ceo, President
Phone
(443) 548-2201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

6324 Corporate CT
Fort Myers, FL 33919-3507

Mailing address

400 Redland CT
Suite 114
Owings Mills, MD 21117-3270
Phone (443) 548-2200

Other names 1

  • Active Day of Fort Myers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Active Day FL Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760525430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 REDLAND CT",
            "address_2": "SUITE 114",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173270",
            "telephone_number": "443-548-2200",
            "fax_number": "443-548-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 CORPORATE CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193507",
            "telephone_number": "239-482-4459",
            "fax_number": "239-482-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE DAY FL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "CHAIRMAN, CEO, PRESIDENT",
        "authorized_official_telephone_number": "443-548-2201"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Day of Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.