Active Care Physical Therapy & Spine Center, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

102576 Issued in MO

Legal business name

ACTIVE CARE PHYSICAL THERAPY & SPINE CENTER, LLC

Practice address

5497A Highway 54
Osage Beach, MO 65065-3026

Phone

(573) 302-1288

Fax

(573) 302-1384

NPI assigned

Mar 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael L McClaughry, P TNPI 1912031493

Title

Partner

Phone

(573) 302-1288

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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.

• Michael L McClaughry, P T

  • Physical Therapist
  • Osage Beach, MO
  • NPI 1912031493
  Medicare reassignment Care Compare group NPD Authorized official
• Lyle R Rasmussen, P T

  • Physical Therapist
  • Osage Beach, MO
  • NPI 1982738860
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952362352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5497A HIGHWAY 54",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653026",
            "telephone_number": "573-302-1288",
            "fax_number": "573-302-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5497A HIGHWAY 54",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650653026",
            "telephone_number": "573-302-1288",
            "fax_number": "573-302-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CARE PHYSICAL THERAPY & SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCCLAUGHRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "573-302-1288",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P T"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MO",
            "license": "102576",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "189021",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Pauline Abbott, DO
• Access Dental Services LP (Access Dental & Dentures)
• Add Life Chiropractic & Wellness Center, Inc
• Baron Scott Adkins, D.O.
• Ads Osage Beach LP
• Advanced Physical Therapy Solutions
• Advanced Radiology LLC

• Physical Therapy Clinic/Center in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Physical Therapy Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.