ACTIVE SPINE PHYSICAL THERAPY, LLC (NPI# 1023568540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023568540 |
| Entity Type | Organization |
| Organization Name | ACTIVE SPINE PHYSICAL THERAPY, LLC |
| Other Organization Name | ACTIVE PHYSICAL THERAPY |
| Practice Address |
10110 Nicholas St Ste 100 Omaha NE 68114 |
| Mailing Address |
10110 Nicholas St Ste 100 Omaha NE 68114-2185 |
| Practice Telephone | 4029322888 |
| Practice Fax Number | 4029322899 |
| Mailing Telephone | 4029322888 |
| Mailing Fax Number | 4029322899 |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2018-12-03 |
| Authorized Official Name | NICHOLAS CHRISTOPHER MUCHOWICZ (PT) |
| Authorized Official Telephone | 4029322888 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
3643 | NE | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 3643 | 05 | |
| NE | STATE LICENSE | 3643 | 01 |
| Other Name | Type Code |
|---|---|
| Active Physical Therapy | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10110 Nicholas St Ste 100, Omaha, NE 68114 | 4029322888 | 4029322899 |
| 7919 Wakeley Plz, Omaha, NE 681143677 | 4029322888 | 4029322899 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508139494 | Active Spine Physical Therapy, LLC | Occupational Therapist | 13220 Birch Dr Ste 200, Omaha, NE 68164-5434 | 2012-02-22 |
| Street Address |
10110 NICHOLAS ST STE 100 |
| City | OMAHA |
| State | NE |
| Zip Code | 68114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689237356 | Jared Nathan Holthaus | Optometrist | 625 N. 98th St, Omaha, NE 68114 | 2019-04-18 |
| 1346701869 | On Site Health and Wellness, LLC | Dietitian, Registered | 7905 Pacific Street, Omaha, NE 68114 | 2019-03-27 |
| 1801301205 | Logan Johnson | Specialist/Technologist | 8803 Webster Plz, Omaha, NE 68114 | 2017-12-06 |
| 1992224687 | Douglas Medical Supplies | Durable Medical Equipment & Medical Supplies | 7914 W Dodge Rd Ste 916, Omaha, NE 68114 | 2017-09-13 |
| 1417400706 | Kayla Ann Leddy | Counselor | 7701 Pacific St Ste 100a, Omaha, NE 68114 | 2016-08-03 |
| 1134561103 | Julio Cesar Deleon Iv | Counselor | 9212 California Plaza #308, Omaha, NE 68114 | 2013-07-19 |
| 1477992261 | Nicole Janine Lecci | Dentist | 8910 Indian Hills Drive, Suite 200, Omaha, NE 68114 | 2013-06-14 |
| 1538504436 | Christian Louis Barney | Radiology | 8303 Dodge St Ste Ll6, Omaha, NE 68114 | 2013-05-06 |
| 1558606665 | Nbd Solutions | Durable Medical Equipment & Medical Supplies | 327 N 78 Street, Omaha, NE 68114 | 2012-11-29 |
| 1831479401 | Nebraska Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1919 N 90th St, Omaha, NE 68114 | 2011-08-26 |
| Find all providers in zip 68114 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831681691 | Bussey Physical Therapy, LLC | Clinic/Center | 10156 S 168th Ave Ste 3, Omaha, NE 68136-4240 | 2018-06-06 |
| 1689121360 | Specialized Physical Therapy | Clinic/Center | 7611 Pacific St, Omaha, NE 68114-5420 | 2016-09-09 |
| 1811440571 | Coreworks Physical Therapy | Clinic/Center | 11303 Wright Cir, Omaha, NE 68144-4738 | 2016-07-29 |
| 1760738652 | Mcguigan Physical Therapy Specialists LLC | Clinic/Center | 15825 W Maple Rd, Suite 102, Omaha, NE 68116-8253 | 2012-07-28 |
| 1659675635 | Physiotherapy Associates, Inc | Clinic/Center | 200 S 31st Ave, Suite 4101, Omaha, NE 68131-1404 | 2011-01-05 |
| 1932414604 | Community Rehab Inc. | Clinic/Center | 12301 No. 149th Circle, Ridgewood Clubhouse, Omaha, NE 68007 | 2010-08-18 |
| 1083859680 | The Rehab Guru, P.C. | Clinic/Center | 366 N 114th St, 16909 Burke St. Suite 200, Omaha, NE 68154-2517 | 2008-12-10 |
| 1174654388 | Occupational Health Centers of Nebraska, P.C. | Clinic/Center | 2900 F St, Omaha, NE 68107-1533 | 2007-03-08 |
| 1407987654 | Occupational Health Centers of Nebraska, P.C. | Clinic/Center | 9602 M St, Omaha, NE 68127-2053 | 2007-03-08 |
| 1508944638 | East & West Physical Therapy LLC | Clinic/Center | 2919 S 120th St, Omaha, NE 68144-4310 | 2006-11-02 |
| Find all providers in OMAHA | ||||
Please comment or provide details below to improve the information on ACTIVE SPINE PHYSICAL THERAPY, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.