NPIMap

Organization Active NPI

Active Family Chiropractic Center LLC

  • Clinic/Center
  • Green Lake, WI
National Provider Identifier
1992945182
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ACTIVE FAMILY CHIROPRACTIC CENTER LLC
Practice address
610 South St
Green Lake, WI 54941-9496
Phone
(920) 229-7215
NPI assigned
Feb 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Andrea M King, DC
Title
Owner
Phone
(920) 229-7215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X WI Primary

Addresses

Primary practice location

610 South St
Green Lake, WI 54941-9496

Mailing address

PO Box 163
Green Lake, WI 54941-0163
Phone (920) 229-7215

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1992945182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549410163",
            "telephone_number": "920-229-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SOUTH ST",
            "city": "GREEN LAKE",
            "state": "WI",
            "postal_code": "549419496",
            "telephone_number": "920-229-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE FAMILY CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-229-7215",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.