Base Vitality Pllc is a medicare enrolled "Clinic/center" provider in Kalispell, Montana. Their current practice location is
103 Ponderosa Ln, Kalispell, Montana. You can reach out to their office (for appointments etc.) via phone at
(406) 220-5058.
Base Vitality Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Base Vitality Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1114727237.
Healthcare Provider's Profile
| Full Name | Base Vitality Pllc |
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| Type | Facility |
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| Speciality | Clinic/center |
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| Location | 103 Ponderosa Ln, Kalispell, Montana |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1114727237
- Provider Enumeration Date: 03/17/2025
- Last Update Date: 02/02/2026
Medicare PECOS Information:
- PECOS PAC ID: 1254857873
- Enrollment ID: O20250428001555
Medical Identifiers
Medical identifiers for Base Vitality Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114727237 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Base Vitality Pllc acts as a billing entity for following providers:
| Provider Name | Andrea L Emde |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1124538962
PECOS PAC ID: 8921410424
Enrollment ID: I20211118001975 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Base Vitality Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Base Vitality Pllc
103 Ponderosa Ln,
Kalispell, MT 59901-6833
Ph: (406) 220-5058 | Base Vitality Pllc
103 Ponderosa Ln,
Kalispell, MT 59901-6833
Ph: (406) 220-5058 |
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