Active NPI
VVMC Diversified Services Inc
- Cardiovascular Disease Physician
- Vail, CO
National Provider Identifier
1265616627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- Legal business name
- VVMC DIVERSIFIED SERVICES INC
- Practice address
- 108 South Frontage Road West
206
Vail, CO 81657 - Phone
- (970) 476-1110
- Fax
- (970) 476-7319
- NPI assigned
- Dec 20, 2007
- Organization subpart
- Yes
- Parent organization
- VVMC DIVERSIFIED SERVICES INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Charles W Crevling
- Title
- Cfo
- Phone
- (970) 479-7238
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | Primary |
Addresses
Primary practice location
108 South Frontage Road West
206
Vail, CO 81657
Mailing address
PO Box 848997
Boston, MA 02284-8997
Phone (970) 476-1110
Other names 1
- Avanti Cardiology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080919000433 | CO | Part B Supplier - Clinic/Group Practice | 8628145414 |
Receives reassigned benefits from 26 practitioners 22 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Vail, CO; Loveland, CO; Leadville, CO; Greeley, CO; Edwards, CO; Fort Collins, CO; Aurora, CO; Eagle, CO… |
Other NPIs on the same Medicare enrollment 22
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Cardiovascular Disease Physician
- Edwards, CO
- NPI 1053909663
O20080919000433
-
- Cardiovascular Disease Physician
- Greeley, CO
- NPI 1306599576
O20080919000433
-
- Cardiovascular Disease Physician
- Dillon, CO
- NPI 1497329643
O20080919000433
National Provider Directory
National Provider Directory- Part of
- VVMC Diversified Services
Locations
108 S Frontage Rd W
Ste 206
Vail, CO 81657
Phone (970) 306-5089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1229385600000",
"number": "1265616627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 848997",
"city": "BOSTON",
"state": "MA",
"postal_code": "022848997",
"telephone_number": "970-476-1110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 SOUTH FRONTAGE ROAD WEST",
"address_2": "206",
"city": "VAIL",
"state": "CO",
"postal_code": "81657",
"telephone_number": "970-476-1110",
"fax_number": "970-476-7319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VVMC DIVERSIFIED SERVICES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VVMC DIVERSIFIED SERVICES INC",
"enumeration_date": "2007-12-20",
"last_updated": "2008-12-16",
"status": "A",
"authorized_official_last_name": "CREVLING",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "970-479-7238",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Avanti Cardiology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Vail, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.