Provider Demographics
NPI:1639172331
Name:JOINT ACTIVE SYSTEMS, INC
Entity Type:Organization
Organization Name:JOINT ACTIVE SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GOVERNMENTAL AFFAIRS
Authorized Official - Prefix:MS
Authorized Official - First Name:BECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-342-3412
Mailing Address - Street 1:2600 S RANEY ST
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-4219
Mailing Address - Country:US
Mailing Address - Phone:217-342-3412
Mailing Address - Fax:217-347-3384
Practice Address - Street 1:2600 S RANEY ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-4219
Practice Address - Country:US
Practice Address - Phone:217-342-3412
Practice Address - Fax:217-347-3384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000238332B00000X, 332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2571346OtherBLUE CROSS BLUE SHIELD IL
IL2571346OtherBLUE CROSS BLUE SHIELD IL
IL=========001Medicaid
MA47922OtherFALLON COMMUNITY HEALTH
IL0658520001Medicare NSC
PA60989OtherGEISINGER HEALTH PLAN
MN685892900OtherMN HEALTH CARE PROGRAM
NMNM00TA89OtherBLUE CROSS BLUE SHIELD NM
UT103004512101OtherINTERMOUNTAIN HEALTH CARE
IL2571346OtherBLUE CROSS BLUE SHIELD IL
9120OtherGENTIVA CARE CENTRIX
MI1758OtherNORTHWOOD, INC
MA391854OtherBLUE CROSS BLUE SHIELD MA
195670OtherMULTIPLAN, INC
NY349962OtherMVP HEALTH PLAN
MN71351OtherHEALTHPARTNERS
IL=========001Medicaid
MO337939OtherHEALTHLINK, INC
MN82-00197OtherMEDICA
ID10028103OtherREGENCE BLUE SHIELD ID