ACTIVE LIFESTYLE CHIROPRACTIC NPI 1083905301

NPI Information

  • NPI: 1083905301
  • Provider Name: ACTIVE LIFESTYLE CHIROPRACTIC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • Address: 16515 S 40TH ST
    SUITE 129
    PHOENIX, AZ
    ZIP 85048
  • Phone: (480) 704-1050

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NPI Details

ACTIVE LIFESTYLE CHIROPRACTIC is a chiropractor in Phoenix, AZ. The provider is 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. ACTIVE LIFESTYLE CHIROPRACTIC NPI is 1083905301. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

16515 S 40TH ST
SUITE 129
PHOENIX, AZ
ZIP 85048-558
Phone: (480) 704-1050
Fax: (480) 704-0109

The provider's authorized official is Jennifer Renee Winton .
The authorized official title is Owner and has the following contact phone number (480) 704-1050.

The enumeration date for this NPI number is 4/20/2011 and was last updated on 4/20/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor7750ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1U98818MEDICARE UPINARIZONA
2Z111783OTHERPTAN
3111783MEDICARE PINARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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