ACTIVE REHABILITATION AND CONDITIONING , NPI 1285747667 — ARC ATHLETICS in NEW YORK (NY)

NPI 1285747667

13+ Years Experience Organization

ACTIVE REHABILITATION AND CONDITIONING

Other organization name: ARC ATHLETICS. Name type code: 3 - doing business as (d/b/ a) name.

08/17/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1285747667
NPI NUMBER

About ACTIVE REHABILITATION AND CONDITIONING

ACTIVE REHABILITATION AND CONDITIONING is a provider established in NEW YORK, NY. The NPI number of ACTIVE REHABILITATION AND CONDITIONING is 1285747667 and was assigned on 08/17/2006. The practitioners primary taxonomy code is: 2255A2300X with license number: 000780-1 NY .

Mailing address

  • City: NEW YORK
  • State: NY
  • Postal code: 100277948
  • Phone: 2122816412
  • Address: 646 W 131ST ST
  • Address 2: SUITE #301

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1285747667
  • Phone : 2122816412
  • Postalcode : 100277948
  • Address : 646 W 131ST ST SUITE #301

Provider taxonomy - Specialist/Technologist

  • Taxonomy code: 2255A2300X
  • License number: 000780-1
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Taxonomy description: Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor"s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.

Contacts:

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  • ACTIVE REHABILITATION AND CONDITIONING
  • Address : 646 W 131ST ST SUITE #301
  • Region : NEW YORK, NY
  • NPI : 1285747667
  • Phone : 2122816412
  • Postalcode : 100277948

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 2122816412
  • Title or position : OWNER
  • Credentials : MA, ATC, CSCS

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address646 W 131ST ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE #301
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code100277948
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2122816412
The telephone number associated with the location address of the provider being identified.
NPI1285747667
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12255A2300X
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor"s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
Provider Enumeration Date08/17/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)ACTIVE REHABILITATION AND CONDITIONING
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameARC ATHLETICS
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address646 W 131ST ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE #301
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameNEW YORK
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code100277948
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2122816412
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Authorized Official Last NameSCHAFER
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameEUGENE
The first name of the authorized official
Authorized Official Middle NameSPENCER
The middle name of the authorized official
Authorized Official Title or PositionOWNER
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextMA, ATC, CSCS
Authorized Official Credential Text
Authorized Official Telephone Number2122816412
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #12255A2300X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Specialist/Technologist
Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor"s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration.
Provider License Number 1000780-1
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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