Active NPI
Active Living Chiropractic Inc
- Chiropractor
- Greenville, NC
National Provider Identifier
1912220690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4057
- Legal business name
- ACTIVE LIVING CHIROPRACTIC INC
- Practice address
- 704 E. Arlington Blvd.
Greenville, NC 27858 - Phone
- (252) 756-6111
- Fax
- (252) 756-6904
- NPI assigned
- Mar 9, 2010
- Last updated
- Apr 24, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Tabatha Bullock Wirth
- Title
- Billing/Wife
- Phone
- (252) 756-6111
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4057 | NC | Primary |
Addresses
Primary practice location
704 E. Arlington Blvd.
Greenville, NC 27858
Mailing address
704 E. Arlington Blvd.
Greenville, NC 27858
Phone (252) 756-6111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
704 E Arlington Blvd
Greenville, NC 27858
Phone (252) 756-6111
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Chiropractor
- Raleigh, NC
- NPI 1356617963
-
- Chiropractor
- Greenville, NC
- NPI 1396077087
-
- Chiropractor
- Greenville, NC
- NPI 1528745155
-
- Chiropractor
- Greenville, NC
- NPI 1710332705
-
- Chiropractor
- Greenville, NC
- NPI 1831885078
-
- Chiropractor
- Meridian, ID
- NPI 1841707007
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682294400000",
"number": "1912220690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 E. ARLINGTON BLVD.",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27858",
"telephone_number": "252-756-6111",
"fax_number": "252-756-6904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 E. ARLINGTON BLVD.",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "27858",
"telephone_number": "252-756-6111",
"fax_number": "252-756-6904"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACTIVE LIVING CHIROPRACTIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-09",
"last_updated": "2023-04-24",
"certification_date": "2023-04-24",
"status": "A",
"authorized_official_last_name": "WIRTH",
"authorized_official_first_name": "TABATHA",
"authorized_official_middle_name": "BULLOCK",
"authorized_official_title_or_position": "BILLING/WIFE",
"authorized_official_telephone_number": "252-756-6111",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NC",
"license": "4057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.