Active Mobility, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

010714845 Issued in SC

Legal business name

ACTIVE MOBILITY, LLC

Practice address

18 Leinbach Dr
Unit E
Charleston, SC 29407-7916

Phone

(843) 377-0847

Fax

(843) 377-0845

NPI assigned

Jan 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Clarence R Hooper Jr., CPO

Title

Ceo

Phone

(843) 577-9577

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Carolina Orthotics and Prosthetics LLC

  • Prosthetic/Orthotic Supplier
  • Columbia, SC
  • NPI 1861813867

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1811968720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3465 W MONTAGUE AVE STE 101",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294185938",
            "telephone_number": "843-577-9577",
            "fax_number": "843-577-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LEINBACH DR",
            "address_2": "UNIT E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294077916",
            "telephone_number": "843-377-0847",
            "fax_number": "843-377-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE MOBILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "843-577-9577",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SC",
            "license": "010714845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2440",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Achanti, APRN
• Achieving at Play, LLC
• Steven Ira Ackerman, MD
• Susan Ackerman, MD
• Active Life, LLC
• Active SC One, Inc.
• Ad of South Carolina LLC
• Taylor Nicole Adam
• Heather Adame, PHD
• Carolina Adams, MD

• Prosthetic/Orthotic Supplier in Charleston, SC
• Providers in Charleston, SC by specialty
• Prosthetic/Orthotic Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; 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.