Connor Thomas Wall

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0017394 Issued in CO

Practice address

564 Highway 133
La Fontana Plaza
Carbondale, CO 81623

Phone

(970) 963-2700

NPI assigned

Dec 4, 2020

Last updated

Dec 4, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vail Clinic IncGroup PAC ID 3577475714, 117 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75.38 of 100Reported as group

Quality

55.42

Promoting interoperability

96

Improvement activities

40

Cost

65.85

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vail Clinic, Inc.

  dba Vail Health Hospital

  • General Acute Care Hospital
  • Vail, CO
  • NPI 1992812333
  Medicare reassignment Care Compare group NPD
• Brownell Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Carbondale, CO
  • NPI 1902179120

  Physical Therapist

  Medicare reassignment NPD
• Vail Clinic Inc

  dba Howard Head Sports Medicine at Frisco

  • Clinic/Center
  • Frisco, CO
  • NPI 1588211791
  NPD
• Vail Clinic, Inc.

  dba Precourt Healing Center

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

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

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1821693995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 VILLAGE RD",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "816231567",
            "telephone_number": "970-618-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 HIGHWAY 133",
            "address_2": "LA FONTANA PLAZA",
            "city": "CARBONDALE",
            "state": "CO",
            "postal_code": "81623",
            "telephone_number": "970-963-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "CONNOR",
        "middle_name": "THOMAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0017394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Marie Vespa, LPC, MAC
• Jayson Vezzoso, M.T.
• Maria Vidaurri
• Eric Vining, D.C.
• VP Mobile Haircut Services LLC.
• Robert Erik Wardell, LPCC
• Carol Warner, M.A.
• Julie Warren, PT
• Morgan Mischer Warth, LPC
• Vanessa Way, DPT

• Physical Therapist in Carbondale, CO
• Providers in Carbondale, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.