Active Life Orthotics and Prosthetics Corp

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP

Practice address

124 Alvarado Dr SE
Albuquerque, NM 87108-2940

Phone

(505) 266-1700

Fax

(505) 349-5170

NPI assigned

Jun 10, 2019

Organization subpart

No

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

Authorized official

Name

Pallavi Nemani

Title

Compliance Officer

Phone

(512) 552-6311

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702512000000",
    "number": "1891354197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 ALVARADO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082940",
            "telephone_number": "505-266-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 ALVARADO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082940",
            "telephone_number": "505-266-1700",
            "fax_number": "505-349-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE ORTHOTICS AND PROSTHETICS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "PALLAVI",
        "authorized_official_title_or_position": "COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "512-552-6311"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Prosthetic/Orthotic Supplier in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.