DR. MATTHEW T PROVENCHER (NPI# 1831162759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831162759 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW T PROVENCHER |
| Credential | MD |
| Practice Address |
181 W Meadow Dr Suite 400 Vail CO 81657-5242 |
| Practice Telephone | 9704761100 |
| Practice Fax Number | 9704795835 |
| Mailing Telephone | 9704761100 |
| Mailing Fax Number | 9704795835 |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2016-03-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
56291 | CO | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
255099 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
181 W MEADOW DR SUITE 400 |
| City | VAIL |
| State | CO |
| Zip Code | 81657-5242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497133 | Joe E. Monk | Anesthesiology | 181 W Meadow Dr, Vail, CO 81657-5242 | 2005-06-14 |
| 1689283749 | Healthone Clinic Services - Pediatric Specialties LLC | Surgery | 181 W Meadow Dr, Vail, CO 81657-5242 | 2020-07-24 |
| 1245854405 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 181 W Meadow Dr, Vail, CO 81657-5242 | 2020-06-03 |
| 1023632320 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 181 W Meadow Dr, Vail, CO 81657-5242 | 2020-06-02 |
| 1649801382 | Brooke Frances Milliet | Physical Therapist | 181 W Meadow Dr, Vail, CO 81657-5242 | 2020-01-31 |
| 1053962563 | Joseph Roy Cardwell | Pharmacist | 181 W Meadow Dr, Vail, CO 81657-5242 | 2019-09-25 |
| 1760044960 | Claire Hsing | Physical Therapist | 181 W Meadow Dr, Vail, CO 81657-5242 | 2019-07-08 |
| 1710443122 | Matilda Gray | Physician Assistant | 181 W Meadow Dr, Vail, CO 81657-5242 | 2019-02-11 |
| 1609355759 | Karen Ann Schleper | Physical Therapist | 181 W Meadow Dr, Vail, CO 81657-5242 | 2018-08-09 |
| 1427543347 | Henry David Scholz | Physical Therapist | 181 W Meadow Dr, Vail, CO 81657-5242 | 2018-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164077897 | Vail Clinic, Inc. | Clinic/Center | 108 S. Frontage Road West, Vail, CO 81657 | 2019-08-08 |
| 1275048522 | Michelle Fitzgerald | Nurse Practitioner | 180 South Frontage Rd, Vail, CO 81657 | 2017-12-08 |
| 1972975662 | Narda Reigel | Counselor | 2488 Garmisch Drive, Vail, CO 81657 | 2015-10-21 |
| 1235511551 | Christopher James Beatton | Specialist | Howard Head Sports Medicine, Vail Valley Medical Centre 181 W Meadow Dr, Vail, CO 81657 | 2015-06-23 |
| 1558748384 | Stephanie Facchini | Specialist/Technologist | 40928 Hwy 6, Unit 2d, Vail, CO 81657 | 2015-04-30 |
| 1225299316 | Vvmc Diversified Services | Specialist | 180 S Frontage Road West, Suite 306, Vail, CO 81657 | 2008-06-20 |
| 1265616627 | Vvmc Diversified Services Inc | Internal Medicine | 108 South Frontage Road West, 206, Vail, CO 81657 | 2007-12-20 |
| 1336336346 | Laura Jean Olderog | Occupational Therapist | Vvmc,181 West Meadow Dr., Vail, CO 81657 | 2007-10-03 |
| 1720281983 | Darlene Traboscia Hoffman | Psychologist | 953 So Frontage Rd W, Vail, CO 81657 | 2007-06-06 |
| 1053512582 | Lindsey Ann Mackellar | Physician Assistant | 181 West Meadow Dr, Vail, CO 81657 | 2007-05-31 |
| Find all providers in zip 81657 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952781734 | Donovan Whitney Johnson | Orthopaedic Surgery | 181 W Meadow Dr, Vail, CO 81657-5242 | 2015-06-05 |
| 1538251574 | Leslie B Vidal | Orthopaedic Surgery | 181 W Meadow Dr Ste 400, Vail, CO 81657-5058 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884057 | Scl Health Medical Group - Denver, LLC | Orthopaedic Surgery | 1830 N Franklin St Ste 340, Denver, CO 80218-1128 | 2020-09-02 |
| 1700498797 | Colorado Sports Medicine and Orthopaedics | Orthopaedic Surgery | 4500 E 9th Ave Ste 420, Denver, CO 80220-3931 | 2020-08-20 |
| 1033668322 | University Physicians, Incorporated | Orthopaedic Surgery | 10103 Ridgegate Pkwy Ste 100, Cu Sports Medicine Sdh Lonetree, Lone Tree, CO 80124-5520 | 2016-09-27 |
| 1750763017 | Ryan Jahn | Orthopaedic Surgery | 2150 Stadium Dr 2nd Floor, Boulder, CO 80309-1029 | 2015-06-23 |
| 1518353218 | Valley View Hospital Association | Orthopaedic Surgery | 1830 Blake Ave Ste 207, Glenwood Spgs, CO 81601-4261 | 2015-04-09 |
| 1326276783 | Thomas P Moore Md Phd PC | Orthopaedic Surgery | 32 Crested Mt. Way, Mt. Crested Butte, CO 81225 | 2009-06-24 |
| 1396919858 | Stephanie Watson Mayer | Orthopaedic Surgery | 13123 E 16th Ave # B060, Aurora, CO 80045-7106 | 2008-04-16 |
| 1689889966 | Orthopedic Surgery & Sports Medicine Specialist | Orthopaedic Surgery | 9141 Grant St Ste 10, Thornton, CO 80229-4374 | 2007-05-11 |
| 1023117850 | Rocky Mountain Trauma Services Proff LLC | Orthopaedic Surgery | 13918 E Mississippi Ave, Suite 473, Aurora, CO 80012 | 2006-09-21 |
| 1215045133 | Andrew W Parker | Orthopaedic Surgery | 4700 E.hale Pkwy, Ste 550, Denver, CO 80220-4053 | 2006-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.