BASE MEDICAL SPA (NPI# 1396202776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396202776 |
| Entity Type | Organization |
| Organization Name | BASE MEDICAL SPA |
| Practice Address |
442 N Calumet Rd Chesterton IN 46304-2489 |
| Practice Telephone | 2196446716 |
| Mailing Telephone | 2196446716 |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |
| Authorized Official Name | BRANDI L ROBERTSON (OWNER) |
| Authorized Official Telephone | 2196446716 |
| Authorized Official Credential | RN |
| Is Organization Subpart | Y |
| Parent Organization Name | BASE SPA & WELLNESS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Street Address |
442 N CALUMET RD |
| City | CHESTERTON |
| State | IN |
| Zip Code | 46304-2489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609042498 | Autumn M Vendramin | Counselor | 442 N Calumet Rd, Ste 100, Chesterton, IN 46304-2489 | 2008-05-01 |
| 1679915193 | Lisa Mae Daube | Counselor | 442 N Calumet Rd, Suite 100, Chesterton, IN 46304-2489 | 2013-07-25 |
| 1427354901 | Life Strategies, LLC | Behavioral Analyst | 442 N Calumet Rd, Suite 100, Chesterton, IN 46304-2489 | 2011-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274268 | Trinity Healthcare Inc. | Occupational Therapist | 2300 Village Point, Chesterton, IN 46304 | 2019-09-19 |
| 1962987206 | Kara Polus | Physical Therapy Assistant | 1595 S Calumet Rd Suite 3, Chesterton, IN 46304 | 2018-10-02 |
| 1275024481 | Karson Rice | Developmental Therapist | 1595 S Calumet Rd, Suite 3, Chesterton, IN 46304 | 2018-05-23 |
| 1720527765 | Alina Broski I | Occupational Therapy Assistant | 1120 S. Calument Road, Suite 3, Chesterton, IN 46304 | 2017-02-22 |
| 1538612015 | Muhammad Ziad Souqiyyeh | Internal Medicine | 3100 Village Pt Ste 102, Chesterton, IN 46304 | 2016-08-01 |
| 1942671656 | Samantha Stremich | Psychologist | 1496 Pope Ct # 2, Chesterton, MI 46304 | 2015-10-08 |
| 1669852299 | Deborah Joan Krause | Physical Therapy Assistant | 780 Dickinson Rd., Addison Pointe Health & Rehab Center, Chesterton, IN 46304 | 2015-06-09 |
| 1538462338 | Sunil Patel Md. P.C. | Internal Medicine | 1140 S. Calumet Road, Suite #2, Chesterton, IN 46304 | 2010-12-16 |
| 1629301981 | Lindsay Allison Munden | Nurse Practitioner | 505 County Road 1100 North, Chesterton, IN 46304 | 2009-09-17 |
| 1881851509 | Total Renal Care Inc | Clinic/Center | 711 Plaza Dr, Ste 6, Chesterton, IN 46304 | 2008-05-20 |
| Find all providers in zip 46304 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654070 | Providence Medical Associates LLC | Clinic/Center | 1935 N Capitol Ave Ste 107, Indianapolis, IN 46202-6403 | 2020-09-18 |
| 1447866462 | Firstlines, Tjs, LLC | Clinic/Center | 11725 Illinois St Ste 550, Carmel, IN 46032-3009 | 2020-09-16 |
| 1902429251 | Telacare Health Solutions, LLC | Clinic/Center | 11650 Olio Rd Ste 1000-172, Fishers, IN 46037-7619 | 2020-05-21 |
| 1275001489 | Decatur County Memorial Hospital | Clinic/Center | 955 N Michigan Ave Ste 2, Greensburg, IN 47240-1487 | 2018-11-06 |
| 1285164509 | Better Quality of Life Care Md, PC | Clinic/Center | 8334 Beech Ave, Munster, IN 46321-1440 | 2017-06-19 |
| 1639622236 | Fordem Health, LLC | Clinic/Center | 1313 Park Dr, Munster, IN 46321-2634 | 2016-07-31 |
| 1447619747 | Sanford Dermatology | Clinic/Center | 400 W Green Meadows Dr Ste 110, Greenfield, IN 46140-3205 | 2016-02-15 |
| 1306222757 | Midwest Wellness LLC | Clinic/Center | 6822 E 82nd St Ste 310, Indianapolis, IN 46250-1677 | 2015-08-08 |
| 1053657775 | Earthen Vessels Nurse Midwifery LLC | Clinic/Center | 251 Airport North Office Park, Fort Wayne, IN 46825-6702 | 2012-12-27 |
| 1861757023 | Integrative Therapeutics LLC | Clinic/Center | 11074 Woods Bay Ln, Indianapolis, IN 46236-9020 | 2012-07-12 |
| Find all providers with the same taxonomy | ||||
| City | CHESTERTON |
| Zip Code | 46304 |
Please comment or provide details below to improve the information on BASE MEDICAL SPA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.