Vitalogy EMS LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VITALOGY EMS LLC

Practice address

468 Ash Rd
Kalispell, MT 59901-2325

Phone

(406) 270-6955

Fax

(406) 309-2127

NPI assigned

Aug 31, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Brodie Verworn

Title

President

Phone

(406) 546-1232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1164190567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 SHADOW LN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012340",
            "telephone_number": "406-270-6955",
            "fax_number": "406-309-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 ASH RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012325",
            "telephone_number": "406-270-6955",
            "fax_number": "406-309-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALOGY EMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "VERWORN",
        "authorized_official_first_name": "BRODIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-546-1232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Land Ambulance in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.