The Vail Mind Center

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

THE VAIL MIND CENTER

Practice address

210 Edwards Village Blvd
#D209
Edwards, CO 81632

Phone

(646) 523-5264

NPI assigned

May 9, 2019

Last updated

May 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shawntee Ann Lyons

Title

Office Manager

Phone

(720) 434-2207

Specialties & licenses 4

Addresses

Other names 1

• The Child Mind Center Former legal business name

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1063077600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 POTATO PATCH DR",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816574427",
            "telephone_number": "646-523-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EDWARDS VILLAGE BLVD",
            "address_2": "#D209",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "81632",
            "telephone_number": "646-523-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VAIL MIND CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "SHAWNTEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "720-434-2207",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Child Mind Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Edwards, CO
• Providers in Edwards, CO by specialty
• Multi-Specialty Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.