ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC — NPI 1275352940 (Licensed & Credentialed Chiropractic Providers

CMS-1500 Box 24J / 33a • NPI

1275352940

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

111N00000X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor

Box 32 Service Location & ZIP+4

980 FOREST AVE STE 204, PORTLAND, ME, 04103-3336

✓ 9-Digit EDI 837 ZIP+4 (04103-3336)

Practice Phone & Referral Fax

(207) 232-5019

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1275352940 (ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1275352940` (NPI-2 Organization / Facility)
Provider / Legal Name	ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: `111N00000X` (Chiropractor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	980 FOREST AVE STE 204, PORTLAND, ME, 04103-3336
Practice Telephone / Fax	Tel: (207) 232-5019
Administrative Mailing Address	50 WOODRIDGE DR, STEEP FALLS, ME, 04085-6859
Enumeration & Last Sync	Enumerated: 2024-10-09 \| CMS Record Updated: 2024-10-09
Authorized Official	TREVOR BEVANS (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

980 FOREST AVE STE 204, PORTLAND, ME, 04103-3336

🗺️ Open in Google Maps 🏥 More Providers in PORTLAND

🔒 Are you ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (111N00000X)

What Does Taxonomy Code 111N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

ACTIVE LIFE CHIROPRACTIC AND SPORTS INJURY, LLC (NPI #1275352940)