NPIMap

Organization Active NPI

VVMC Diversified Services

  • Cardiovascular Disease Physician
  • Vail, CO
National Provider Identifier
1942890876
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
Practice address
181 W Meadow Dr
Vail, CO 81657-5242
Phone
(970) 476-2451
NPI assigned
Jan 25, 2021
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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X

Addresses

Primary practice location

181 W Meadow Dr
Vail, CO 81657-5242

Mailing address

PO Box 841152
Kansas City, MO 64184-1152
Phone (970) 777-2850

Other names 1

  • VAIL HEALTH CLINIC 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

180 S Frontage Rd W
Ste 5900
Vail, CO 81657
Phone (970) 479-5036

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": "1942890876",
    "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": "641841152",
            "telephone_number": "970-777-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 W MEADOW DR",
            "city": "VAIL",
            "state": "CO",
            "postal_code": "816575242",
            "telephone_number": "970-476-2451"
        }
    ],
    "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VAIL HEALTH CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VAIL HEALTH CLINIC",
            "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.