Organization Active NPI

Vail Clinic, Inc.

Doing business as Howard Head Sports Medicine at Edwards

  • Durable Medical Equipment & Medical Supplies
  • Edwards, CO
National Provider Identifier
1114673415
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
VAIL CLINIC, INC.
Doing business as
Howard Head Sports Medicine at Edwards
Practice address
320 Beard Creek Rd Ste 1100
Edwards, CO 81632-6433
Phone
(970) 476-1225
NPI assigned
Feb 24, 2022
Last updated
Jan 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
VAIL CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Michael G Brown
Title
SVP & Cfo
Phone
(970) 476-7272

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

320 Beard Creek Rd Ste 1100
Edwards, CO 81632-6433

Mailing address

PO Box 840220
Kansas City, MO 64184-0220
Phone (970) 777-2850

Other names 1

  • Howard Head Sports Medicine at Edwards Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VVMC.DIRECT@direct.vvmc.com Health Information Exchange (HIE) Vail Clinic, Inc.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220509001099 CO DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 3577475714 Practice locations: Edwards, CO

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Keystone Medical Center30 organizations share this tax ID, including this one
Part of
Keystone Medical Center

Other organizations with this tax ID 29

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

View all 29

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Vail Health HospitalVail, CO, CCN 060096 Hospital Operational/Managerial Control Feb 7, 1966

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1114673415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840220",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641840220",
            "telephone_number": "970-777-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BEARD CREEK RD STE 1100",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816326433",
            "telephone_number": "970-476-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL CLINIC, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAIL CLINIC, INC.",
        "enumeration_date": "2022-02-24",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SVP & CFO",
        "authorized_official_telephone_number": "970-476-7272"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VVMC.DIRECT@direct.vvmc.com",
            "affiliation": "Y",
            "affiliationName": "Vail Clinic, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "181 W Meadow Dr",
            "city": "Vail",
            "state": "CO",
            "country_code": "US",
            "postal_code": "816575242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Howard Head Sports Medicine at Edwards",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Howard Head Sports Medicine at Edwards",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.