Vail Valley Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0704 Issued in CO

Legal business name

VAIL VALLEY SURGERY CENTER, LLC

Practice address

181 W Meadow Dr # 3R
Vail, CO 81657-5242

Phone

(970) 476-8200

Fax

(970) 477-8215

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jacqueline A Deveric

Title

Director

Phone

(970) 476-8202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vail Valley Surgery Center Vail Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vail Valley Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Edwards, CO
  • NPI 1447539861

  O20040302000654

  Same enrollment

Listed as

Vail Valley Surgery Center LLC Dba Vail Valley Surgery Center VailCCN 06C0001074

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Vail Valley Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vail Valley Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Edwards, CO
  • NPI 1447539861
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vail Clinic Inc

  • Clinic/Center
  • Dillon, CO
  • NPI 1487238796

  Member Of

  NPD member

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Vail Valley Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Edwards, CO
  • NPI 1447539861
  NPPES parent name

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1003944125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1270",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816581270",
            "telephone_number": "970-477-8200",
            "fax_number": "970-477-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W MEADOW DR # 3R",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575242",
            "telephone_number": "970-476-8200",
            "fax_number": "970-477-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL VALLEY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "DEVERIC",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "970-476-8202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CO",
            "license": "0704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67801731",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vail Valley Surgery Center Vail",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vail Health Innovations, LLC
• Vail Physical Therapy, LLC
• Vail Sports Medicine Physical Therapy PC
• Vail Valley Anesthesia, PC
• Vail Valley Emergency Physicians PC
• Vail-Summit Orthopaedics PC
• Vail-Summit Orthopaedics PC
• Vail-Summit Orthopaedics PC
• Elle Valentine, ATC, DPT
• Frances M Velez-Rodriguez, M.D.

• Ambulatory Surgical Clinic/Center in Vail, CO
• Providers in Vail, CO by specialty
• Ambulatory Surgical Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.