A1 Active Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

A1 ACTIVE CARE

Practice address

1016 W Jackson Blvd
Chicago, IL 60607-2914

Phone

(312) 675-8471

Fax

(312) 488-3648

NPI assigned

Oct 1, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Andrew M Lacy Sr.

Title

Member

Phone

(678) 230-7095

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1821491010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072914",
            "telephone_number": "312-675-8471",
            "fax_number": "312-675-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 W JACKSON BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072914",
            "telephone_number": "312-675-8471",
            "fax_number": "312-488-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A1 ACTIVE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "LACY",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "678-230-7095",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.