ACTIVE INTEGRATED MEDICINE LLC (NPI# 1174016331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174016331 |
| Entity Type | Organization |
| Organization Name | ACTIVE INTEGRATED MEDICINE LLC |
| Other Organization Name | ACTIVE INTEGRATED MEDICINE |
| Practice Address |
329 E Platte Ave Fort Morgan CO 80701-3172 |
| Practice Telephone | 9704411117 |
| Mailing Telephone | 9704411117 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | LEIF STEPHENS (ADMINISTRATOR) |
| Authorized Official Telephone | 9704585216 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | NPI | 1346781846 | 01 |
| Other Name | Type Code |
|---|---|
| Active Integrated Medicine | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Active Integrated Medicine LLC | 329 E Platte Ave, Fort Morgan, CO 80701 |
| Street Address |
329 E PLATTE AVE |
| City | FORT MORGAN |
| State | CO |
| Zip Code | 80701-3172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770733297 | Leif Allen Stephens | Chiropractor | 329 E Platte Ave, Fort Morgan, CO 80701-3172 | 2008-09-19 |
| 1841836699 | Karissa Caylene Gayosso | Nurse Practitioner | 329 E Platte Ave, Fort Morgan, CO 80701-3172 | 2019-11-26 |
| 1588122071 | Ashley Bristol | Massage Therapist | 329 E Platte Ave, Fort Morgan, CO 80701-3172 | 2019-03-04 |
| 1215187737 | Proactive Chiropractic LLC | Chiropractor | 329 E Platte Ave, Fort Morgan, CO 80701-3172 | 2008-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376057091 | Michael Bauer | Occupational Therapist | 1000 Lincoln St # Cs4200, Fort Morgan, CO 80701 | 2017-11-17 |
| 1598125262 | Mh Health Care Services, PC | Nurse Practitioner | 1997 East Platte Ave, Suite B, C/o Cargill Employee Health Center, Fort Morgan, CO 80701 | 2016-02-24 |
| 1083091896 | Monica Armijo | Social Worker | 650 E. Walniut, Elizabeth, CO 80701 | 2015-04-30 |
| 1548546179 | David Allen Strand | Pharmacist | 111 East Platte, Fort Morgan, CO 80701 | 2011-10-27 |
| 1780969741 | James Howard Armstrong | Pharmacist | 111 E. Platte Ave, Fort Morgan, CO 80701 | 2011-10-20 |
| 1578880803 | Jean Marie Collins | Counselor | 910 E. Railraod, Fort Morgan, CO 80701 | 2010-04-26 |
| 1811133770 | Charles James Avery | Counselor | 410 Railroad Ave., Fort Morgan, CO 80701 | 2008-12-24 |
| 1306098710 | Stephen Michael Mitchell | Pharmacist | 110 W.platte Ave, Ft.morgan, CO 80701 | 2008-10-16 |
| 1386805265 | State of Nevada | Public Health or Welfare | 1000 E Williams Street, #205, Carson City, NV 80701 | 2008-06-23 |
| 1629240106 | Annette Kay Smith | Counselor | 205 E 6th Ave, Fort Morgan, CO 80701 | 2008-03-25 |
| Find all providers in zip 80701 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | FORT MORGAN |
| Zip Code | 80701 |
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| 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.