Active Motion Physical Therapy, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT228100 Issued in CA

Legal business name

ACTIVE MOTION PHYSICAL THERAPY, PC

Practice address

22600 Lambert St Ste 1204
Lake Forest, CA 92630-1623

Phone

(949) 533-2055

NPI assigned

Sep 26, 2013

Last updated

Sep 26, 2013By 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

Jordan Jesse Turner, P.T.

Title

Shareholder

Phone

(949) 533-2055

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1801223516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22600 LAMBERT ST STE 1204",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 LAMBERT ST STE 1204",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301623",
            "telephone_number": "949-533-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MOTION PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-26",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "JESSE",
        "authorized_official_title_or_position": "SHAREHOLDER",
        "authorized_official_telephone_number": "949-533-2055",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "PT228100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Specialist in California

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