NPIMap

Organization Active NPI

Colorado Mountain Medical, LLC

  • Community/Behavioral Health Agency
  • Vail, CO
National Provider Identifier
1326793076
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COLORADO MOUNTAIN MEDICAL, LLC
Practice address
180 S Frontage Rd W
5800
Vail, CO 81657-5038
Phone
(970) 926-6340
NPI assigned
Feb 21, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Diane VoytkoNPI 1043212525
Title
Physician President
Phone
(970) 845-2903

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

180 S Frontage Rd W
5800
Vail, CO 81657-5038

Mailing address

PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251104003435 CO DME Supplier - Multi-Specialty - Physician 5496087181 Practice locations: Vail, CO

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Colorado Mountain Medical LLC28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Vail Clinic, Inc.

    dba Howard Head Sports Medicine at Basalt DME

    • Durable Medical Equipment & Medical Supplies
    • Basalt, CO
    • NPI 1215670625

    Member Of

    NPD member

Locations

365 Dillon Ridge Rd
Ste 1200
Dillon, CO 80435
Phone (970) 479-7272

377 Sylvan Lake Rd
Ste 120A
Eagle, CO 81631

320 Beard Creek Rd
Ste 100
Edwards, CO 81632
Phone (970) 476-8872

180 S Frontage Rd W
#5800
Vail, CO 81657

Practitioners & affiliated clinicians

Practitioners 72

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1326793076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4330",
            "city": "AVON",
            "state": "CO",
            "postal_code": "816204330",
            "telephone_number": "970-926-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 S FRONTAGE RD W",
            "address_2": "5800",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575038",
            "telephone_number": "970-926-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLORADO MOUNTAIN MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "VOYTKO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PHYSICIAN PRESIDENT",
        "authorized_official_telephone_number": "970-845-2903"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 8, 2022; 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.