ACTIVE LIFE CHIROPRACTIC CLINIC LLC
NPI 1174877955
Chiropractor - Sports Physician in Yakima, WA
About Active Life Chiropractic Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ACTIVE LIFE CHIROPRACTIC CLINIC LLC (NPI 1174877955), doing business as Active Life Chiropractic, is a healthcare organization registered as a sports physician in Yakima, Washington and active in the NPI registry since November 2012. The organization lists Kristina Lynn Coppock, Owner/doctor/office Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Active Life Chiropractic Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Active Life Chiropractic Clinic LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Active Life Chiropractic Clinic LLC's NPI number?
The NPI number for Active Life Chiropractic Clinic LLC is 1174877955. It was assigned to this organization in the NPPES registry on November 1, 2012. The provider is doing business as Active Life Chiropractic.
Where is Active Life Chiropractic Clinic LLC located?
Active Life Chiropractic Clinic LLC is located at 1015 S 40th Ave Ste 21, Yakima, WA 98908. The listed phone number is (509) 965-9820.
What is Active Life Chiropractic Clinic LLC's specialty?
The primary specialty registered for this NPI is Chiropractor, specializing in Sports Physician, with taxonomy code 111NS0005X.
Is Active Life Chiropractic Clinic LLC enrolled in Medicare?
Yes. Active Life Chiropractic Clinic LLC is registered in the Medicare PECOS enrollment system.
When is Active Life Chiropractic Clinic LLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Washington, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Active Life Chiropractic Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Active Life Chiropractic Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Active Life Chiropractic Clinic LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Active Life Chiropractic Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Active Life Chiropractic Clinic LLC was last updated on March 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Active Life Chiropractic Clinic Llc · NPI 1174877955
Sports Physician organization in Yakima, Washington. Organization record, active in the CMS NPPES registry since November 1, 2012.
## Identity
- **NPI:** 1174877955 (Entity type: Organization)
- **Enumerated:** November 1, 2012
- **Primary specialty:** Chiropractor - Sports Physician · taxonomy 111NS0005X
- **Also known as:** Active Life Chiropractic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kristina Coppock, OWNER/DOCTOR/OFFICE MANAGER
## Practice location
- **Address:** 1015 S 40TH AVE STE 21, Yakima, WA 98908-3868
- **Phone:** (509) 965-9820 · **Fax:** (509) 965-9822
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Washington, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians (Chiropractic) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 31, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1174877955) · Data from the CMS NPPES public registry.