Organization Active NPI

Activated Life Chiropractic and Wellness PLLC

Doing business as Activated Life Chiropractic and Wellness

  • Health Service Clinic/Center
  • Great Falls, MT
National Provider Identifier
1992360614
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
ACTIVATED LIFE CHIROPRACTIC AND WELLNESS PLLC
Doing business as
Activated Life Chiropractic and Wellness
Practice address
906 7TH St S
Great Falls, MT 59405-4026
Phone
(406) 770-3800
Fax
(406) 770-3802
NPI assigned
May 8, 2019
Last updated
May 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Dr. Justin Curtis Stilson, DCNPI 1376007187
Title
Owner
Phone
(406) 770-3800

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU Primary

Addresses

Primary practice location

906 7TH St S
Great Falls, MT 59405-4026

Mailing address

906 7TH St S
Great Falls, MT 59405-4026
Phone (406) 770-3800

Other names 1

  • Activated Life Chiropractic and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200430000428 MT Part B Supplier - Clinic/Group Practice 3375973597 Receives reassigned benefits from 1 practitioner
Practice locations: Great Falls, MT

National Provider Directory

National Provider Directory

Locations

1301 12th Ave S
Ste 203
Great Falls, MT 59405
Phone (406) 770-3800

Practitioners & affiliated clinicians

Practitioners 1

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": "1557273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1992360614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 7TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054026",
            "telephone_number": "406-770-3800",
            "fax_number": "406-770-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 7TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054026",
            "telephone_number": "406-770-3800",
            "fax_number": "406-770-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVATED LIFE CHIROPRACTIC AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-08",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "STILSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "CURTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-770-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Activated Life Chiropractic and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Activated Life Chiropractic and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.