NPIMap

Organization Active NPI

Vitality a Professional Corporation

  • Chiropractor
  • Billings, MT
National Provider Identifier
1053716860
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1017 Issued in MT
Legal business name
VITALITY A PROFESSIONAL CORPORATION
Practice address
1918 Broadwater Ave
Billings, MT 59102-4867
Phone
(406) 969-3805
Fax
(406) 794-0809
NPI assigned
Oct 23, 2014
Last updated
Oct 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jeffrey R Mitchell, D.C.NPI 1427149277
Title
Onwer
Phone
(406) 969-3805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1017 MT Primary
Rehabilitation Chiropractor 111NR0400X 1017 MT

Addresses

Primary practice location

1918 Broadwater Ave
Billings, MT 59102-4867

Mailing address

1918 Broadwater Ave
Billings, MT 59102-4867
Phone (406) 969-3805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141104001002 MT Part B Supplier - Clinic/Group Practice 3678795820 Receives reassigned benefits from 3 practitioners
Practice locations: Billings, MT

National Provider Directory

National Provider Directory

Locations

1918 Broadwater Ave
Billings, MT 59102
Phone (406) 652-1923

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1053716860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 BROADWATER AVE",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591024867",
            "telephone_number": "406-969-3805",
            "fax_number": "406-794-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 BROADWATER AVE",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591024867",
            "telephone_number": "406-969-3805",
            "fax_number": "406-794-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ONWER",
        "authorized_official_telephone_number": "406-969-3805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "1017",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MT",
            "license": "1017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.