ACTIVE FOOT AND ANKLE CARE LLC – Foot & Ankle Surgery Podiatrist, NPI 1164773875

ACTIVE FOOT AND ANKLE CARE LLC is a healthcare provider. based in Troy, Ohio. specializing in Foot & Ankle Surgery Podiatrist. The organization holds a License No. 36003402 (OH). The NPI Number for ACTIVE FOOT AND ANKLE CARE LLC is 1164773875

Main info

Organization
Name
ACTIVE FOOT AND ANKLE CARE LLC
NPI
1164773875
Phone
(937) 875-2526
Address
300 S DORSET RD
Authorized Official
WHITNEY RAE HOLSOPPLE OWNER D.P.M
Enumeration Date
21 September 2012
Last Update Date
17 December 2019
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

Provider Addresses for ACTIVE FOOT AND ANKLE CARE LLC

  • 300 S DORSET RD

    TROY, OH 453732635

    Phone: (937) 875-2526

    Fax: (937) 459-5433

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-09-30 (618 days ago).

Enrollment records

1

Earliest due date

2024-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20120925000637OPhysician - PodiatryOH2024-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45373)

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Reviews

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Frequently asked questions

What number should I use to identify ACTIVE FOOT AND ANKLE CARE LLC for billing?
Administrative and clinical systems typically use NPI 1164773875 for ACTIVE FOOT AND ANKLE CARE LLC.
Does the public listing show ACTIVE FOOT AND ANKLE CARE LLC as active?
ACTIVE FOOT AND ANKLE CARE LLC's NPI record reflects an active status in NPPES.
What does the directory say ACTIVE FOOT AND ANKLE CARE LLC does?
Insurance directories may phrase it differently, but here ACTIVE FOOT AND ANKLE CARE LLC maps to Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ACTIVE FOOT AND ANKLE CARE LLC?
ACTIVE FOOT AND ANKLE CARE LLC is associated with Troy, Ohio in the same public data insurers reference.
Can I export ACTIVE FOOT AND ANKLE CARE LLC's record?
You can download the official NPPES record; we summarize key fields for readability.

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ACTIVE FOOT AND ANKLE CARE LLC

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