ACTIVE LIFE LLC (NPI# 1922577659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922577659 |
| Entity Type | Organization |
| Organization Name | ACTIVE LIFE LLC |
| Practice Address |
2804 Forum Blvd Ste 1a Columbia MO 65203-6322 |
| Practice Telephone | 5739997805 |
| Practice Fax Number | 5734464949 |
| Mailing Telephone | 5739997805 |
| Mailing Fax Number | 5734464949 |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |
| Authorized Official Name | SAMUEL HENLEY (DOCTOR) |
| Authorized Official Telephone | 5733561876 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Active Life Chiropractic | Doing Business As Name - Organization |
| Street Address |
2804 FORUM BLVD STE 1A |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65203-6322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285787903 | Christy M Henley | Chiropractor | 2804 Forum Blvd Ste 1a, Columbia, MO 65203-6322 | 2007-01-18 |
| 1922305267 | Samuel Thomas Henley | Chiropractor | 2804 Forum Blvd Ste 1a, Columbia, MO 65203-6322 | 2011-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982229498 | Rebecca Wallace Counseling LLC | Clinic/Center | 207 Peach Way, Suite 110, Columbia, MO 65203 | 2020-06-10 |
| 1144797101 | Mary Zhang | Family Medicine | 200 Southampton Drive, Ste 102, Columbia, MO 65203 | 2018-10-29 |
| 1871090258 | Hina Omer Khokhar | Pathology | 4601 Apt F West Millbrook Dr, Columbia, MO 65203 | 2018-04-11 |
| 1154820157 | David Vincent Spencer | Internal Medicine | 201 W Broadway Building, Suite E, Columbia, MO 65203 | 2018-02-05 |
| 1598283103 | Donna Strickland | Counselor | 201 W Broadway Bldg 2, Suite F, Columbia, MO 65203 | 2017-09-03 |
| 1134643182 | Anna Kathryn Christensen | Physician Assistant | 4107 Baurichter Dr., Columbia, MO 65203 | 2017-08-01 |
| 1558885871 | Juan Camilo Pineda | Internal Medicine | 210 Portland Street Suite 104, Columbia, MO 65203 | 2017-07-28 |
| 1922530096 | The Missing L Inc | Community/Behavioral Health | 3605 S. Providence Rd, Suite 6, Columbia, MO 65203 | 2017-03-29 |
| 1689118010 | Linda Landry | Nurse Practitioner | 1000 W. Nifong, Bldg 2 Suite 150, Columbia, MO 65203 | 2016-12-04 |
| 1417313552 | Brittany Lea Ramirez | Chiropractor | 2001 Corona Rd Ste 205, Columbia, MO 65203 | 2016-01-05 |
| Find all providers in zip 65203 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306470281 | Palmercare Chiropractic Columbia Inc | Chiropractor | 6851 Oak Hall Ln Ste 301, Columbia, MD 21045-5846 | 2020-02-28 |
| 1639700909 | Kylar Sue Mccann | Chiropractor | 4200 Merchant St Ste 105, Columbia, MO 65203-5816 | 2020-01-27 |
| 1447880331 | Alisha Squires | Chiropractor | 2024 Cherry Hill Dr Ste 101, Columbia, MO 65203-5921 | 2020-01-20 |
| 1205476108 | William H. Northern | Chiropractor | 1005 South Main St., Suite A, Columbia, IL 62236-9998 | 2020-01-09 |
| 1285276857 | Unity Chiropractic LLC | Chiropractor | 110 Office Park Dr, Columbia, KY 42728-1380 | 2019-10-15 |
| 1871056846 | John Terrier | Chiropractor | 10630 Little Patuxent Pkwy Ste 329, Columbia, MD 21044-3204 | 2019-04-08 |
| 1417410549 | Matthew Hux | Chiropractor | 1221 Bower Pkwy Ste 108, Columbia, SC 29212-3734 | 2019-04-06 |
| 1841764057 | Nourishing Life Wellness, LLC | Chiropractor | 7300 Grace Dr # 1a, Columbia, MD 21044-2473 | 2019-01-22 |
| 1790259158 | Raquel Heisse | Chiropractor | 1997 Waterfront Dr N Apt E, Columbia, MO 65202-8953 | 2019-01-17 |
| 1548732449 | Midlands Family Chiropractic, LLC | Chiropractor | 6030 Saint Andrews Rd Ste M, Columbia, SC 29212-3164 | 2018-12-18 |
| Find all providers in COLUMBIA | ||||
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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.