NPIMap

Organization Active NPI

Active Day Ky, Inc.

  • Developmental Disabilities Clinic/Center
  • Louisville, KY
National Provider Identifier
1851430367
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ACTIVE DAY KY, INC.
Practice address
1920 Goldsmith LN
Suite 100
Louisville, KY 40218-2073
Phone
(502) 366-5777
Fax
(502) 366-4599
NPI assigned
Feb 5, 2007
Organization subpart
Yes
Parent organization
ACTIVE DAY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Craig Mehnert
Title
Coo
Phone
(215) 642-6600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X
Developmental Disabilities Clinic/Center 261QD1600X Primary
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

1920 Goldsmith LN
Suite 100
Louisville, KY 40218-2073

Mailing address

6 Neshaminy Interplex
Suite 401
Trevose, PA 19053-6964
Phone (215) 642-6600

Other identifiers 2

IdentifierTypeStateIssuer
3300131400MedicaidKY
4300082700MedicaidKY

Other names 1

  • Active Day of Watterson Park Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0981415Active Day of Watterson Park1920 Goldsmith Lane Suite 100, Louisville, KY 40218Certificate of waiverDec 26, 2026

National Provider Directory

National Provider Directory
Tax ID family
Active Day Ky Inc8 organizations share this tax ID, including this one
Part of
Active Day Inc

Other organizations with this tax ID 7

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

Locations

1920 Goldsmith Ln
Ste 100
Louisville, KY 40218
Phone (502) 366-5777

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1851430367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 NESHAMINY INTERPLEX",
            "address_2": "SUITE 401",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536964",
            "telephone_number": "215-642-6600",
            "fax_number": "215-642-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 GOLDSMITH LN",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402182073",
            "telephone_number": "502-366-5777",
            "fax_number": "502-366-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE DAY KY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACTIVE DAY, INC.",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "MEHNERT",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "215-642-6600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3300131400",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4300082700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Active Day of Watterson Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.