NPIMap

Organization Active NPI

Vail Clinic Inc

  • Clinic/Center
  • Eagle, CO
National Provider Identifier
1164077897
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
VAIL CLINIC INC
Practice address
377 Sylvan Lake Rd Ste 100
Eagle, CO 81631-6779
Phone
(970) 328-6715
NPI assigned
Aug 8, 2019
Organization subpart
Yes
Parent organization
VAIL CLINIC INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 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) 479-7272

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Physical Therapy Clinic/Center 261QP2000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

377 Sylvan Lake Rd Ste 100
Eagle, CO 81631-6779

Mailing address

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

Other names 1

  • HOWARD HEAD SPORTS MEDICINE AT EAGLE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000224 CO Part B Supplier - Clinic/Group Practice 3577475714 Receives reassigned benefits from 206 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eagle, CO; Edwards, CO; Frisco, CO; Gypsum, CO; Steamboat Springs, CO; Vail, CO; Dillon, CO; Breckenridge, CO…

Other NPIs on the same Medicare enrollment 23

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

View all 23

National Provider Directory

National Provider Directory
Tax ID family
Vail Valley Med Center30 organizations share this tax ID, including this one
Part of
Vail Valley Med Center

Other organizations with this tax ID 29

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

View all 29

Locations

200 Robinson St
Ste D300
Basalt, CO 81621
Phone (970) 476-1225

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1164077897",
    "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": "377 SYLVAN LAKE RD STE 100",
            "city": "EAGLE",
            "state": "CO",
            "postal_code": "816316779",
            "telephone_number": "970-328-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL CLINIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VAIL CLINIC INC",
        "enumeration_date": "2019-08-08",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "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": "970-479-7272"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOWARD HEAD SPORTS MEDICINE AT EAGLE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.