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Active Lifestyle Medical, LLC

Durable Medical Equipment & Medical Supplies in Tulsa, OK · enumerated 2019 · authorized official Robbie Ely, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1902370885

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Registry record

Entity type Organization (Type 2)
Legal business name Active Lifestyle Medical, LLC
Practice address 5455 S Mingo Rd Ste E, Tulsa, OK, 74146
Phone (918) 576-6765
Fax (888) 605-4113
Enumeration date Jan 14, 2019
Last updated in NPPES May 18, 2022

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Primary

Authorized official

Name Robbie Ely
Title President
Phone (918) 520-8008

Other identifiers

Identifier Type State Issuer
O20190822002462 Other OK MANAGED PLANS
O20190822002462 Other MO MANAGED PLANS
O20190822002462 Medicaid MO -
O20190822002462 Medicaid OK -
O20190822002462 Other KS MANAGED PLANS
O20190822002462 Medicaid KS -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Active Lifestyle Medical, LLC?
NPPES lists Robbie Ely (President) as the authorized official for this organization.
What is the NPI number for Active Lifestyle Medical, LLC?
The NPI for Active Lifestyle Medical, LLC is 1902370885, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2022-05-18.