NPIMap

Organization Active NPI

VVMC Diversified Services

Doing business as Vail Health Clinic Vail East

  • Cardiovascular Disease Physician
  • Vail, CO
National Provider Identifier
1710577648
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
VVMC DIVERSIFIED SERVICES
Doing business as
Vail Health Clinic Vail East
Practice address
108 S Frontage Rd W Ste 306
Vail, CO 81657-5087
Phone
(970) 476-1110
NPI assigned
Jan 25, 2021
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
VVMC DIVERSIFIED SERVICESAs 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

108 S Frontage Rd W Ste 306
Vail, CO 81657-5087

Mailing address

PO Box 841152
Kansas City, MO 64184-1150
Phone (970) 777-2850

Other names 1

  • VAIL HEALTH CLINIC VAIL EAST Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 22

National Provider Directory

National Provider Directory
Part of
VVMC Diversified Services

Locations

108 S Frontage Rd W
Ste 306
Vail, CO 81657

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1710577648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841152",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641841150",
            "telephone_number": "970-777-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S FRONTAGE RD W STE 306",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575087",
            "telephone_number": "970-476-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VVMC DIVERSIFIED SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VVMC DIVERSIFIED SERVICES",
        "enumeration_date": "2021-01-25",
        "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": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VAIL HEALTH CLINIC VAIL EAST",
            "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 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.