NPIMap

Organization Active NPI

Vail Clinic, Inc.

Doing business as Howard Head Sports Medicine at Basalt DME

  • Durable Medical Equipment & Medical Supplies
  • Basalt, CO
National Provider Identifier
1215670625
Registry record updated Jan 9, 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 Basalt DME
Practice address
200 Robinson St Ste D300
Basalt, CO 81621-8464
Phone
(970) 476-1225
NPI assigned
Apr 14, 2022
Last updated
Jan 9, 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 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 2

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

Addresses

Primary practice location

200 Robinson St Ste D300
Basalt, CO 81621-8464

Mailing address

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

Other names 1

  • Howard Head Sports Medicine at Basalt DME 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
O20220813000240 CO DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 3577475714 Practice locations: Basalt, 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

Member organizations 7

Organizations listed as members of this organization in the National Provider Directory.

Locations

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

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.

  • Vail Clinic Inc

    dba Shaw Cancer Clinic at Frisco

    • Clinic/Center
    • Frisco, CO
    • NPI 1003463217

    Operational/Managerial Control

    CMS ownership
  • Vail Clinic Inc

    dba Beaver Creek Medical Center - Service of Vail Health Hospital

    • General Acute Care Hospital
    • Avon, CO
    • NPI 1093361842

    Operational/Managerial Control

    CMS ownership
  • Vail Clinic Inc

    dba Shaw Cancer Center - Service of Vail Health Hospital

    • General Acute Care Hospital
    • Edwards, CO
    • NPI 1144876251

    Operational/Managerial Control

    CMS ownership
  • Vail Clinic, Inc.

    dba Precourt Healing Center

    • General Acute Care Hospital
    • Edwards, CO
    • NPI 1659151009

    Operational/Managerial Control

    CMS ownership
  • Vail Clinic, Inc.

    dba Vail Health Hospital

    • General Acute Care Hospital
    • Vail, CO
    • NPI 1992812333

    Operational/Managerial Control

    CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1649894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1215670625",
    "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": "200 ROBINSON ST STE D300",
            "city": "BASALT",
            "state": "CO",
            "postal_code": "816218464",
            "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": "2022-04-14",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "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": "200 Robinson St Ste D300",
            "city": "Basalt",
            "state": "CO",
            "country_code": "US",
            "postal_code": "816218464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Howard Head Sports Medicine at Basalt DME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Howard Head Sports Medicine at Basalt DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Basalt, CO

Sources for this page

Verify at the official NPI Registry.