NPIMap

Organization Active NPI

Activefit Physical Therapy and Personal Training

  • Physical Therapist
  • Huntley, IL
National Provider Identifier
1881201895
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ACTIVEFIT PHYSICAL THERAPY AND PERSONAL TRAINING
Doing business as
ActiveFit Physical Therapy and Personal Training
Practice address
12172 S. Route 47
#125
Huntley, IL 60142
Phone
(847) 920-7110
Fax
(847) 920-7110
NPI assigned
Sep 24, 2020
Last updated
Sep 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Authorized official

Name
Jessica Swanson
Title
Co-Owner
Phone
(847) 920-7110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

12172 S. Route 47
#125
Huntley, IL 60142

Mailing address

12172 S. Route 47
#125
Huntley, IL 60142
Phone (847) 920-7110

Other identifiers 1

IdentifierTypeStateIssuer
070020797OtherILLICENSE NUMBER

Other names 1

  • ActiveFit Physical Therapy and Personal Training Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201007002888 IL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911326178 Receives reassigned benefits from 2 practitioners
Practice locations: West Dundee, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1881201895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12172 S. ROUTE 47",
            "address_2": "#125",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "60142",
            "telephone_number": "847-920-7110",
            "fax_number": "847-920-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12172 S. ROUTE 47",
            "address_2": "#125",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "60142",
            "telephone_number": "847-920-7110",
            "fax_number": "847-920-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVEFIT PHYSICAL THERAPY AND PERSONAL TRAINING",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-22",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "847-920-7110"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "070020797",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ActiveFit Physical Therapy and Personal Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.