Active Life Acupuncture & Wellness Center

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

065 Issued in AR

Legal business name

ACTIVE LIFE ACUPUNCTURE & WELLNESS CENTER

Practice address

2592 N Gregg Ave Ste 10
Fayetteville, AR 72703-5520

Phone

(479) 358-7690

NPI assigned

Nov 17, 2017

Organization subpart

No

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

Authorized official

Name

Hayden Henningsen

Title

Owner/Practitioner

Phone

(479) 358-7690

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1851805493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 N GREGG AVE STE 10",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 N GREGG AVE STE 10",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035520",
            "telephone_number": "479-358-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE ACUPUNCTURE & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "HENNINGSEN",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "479-358-7690"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "AR",
            "license": "065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Acupuncturist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.