Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mountain Revival Vail, LLC

Organization Public Health & General Preventive Medicine Physician · NPI 1154129815

Mountain Revival Vail, LLC is a Public Health & General Preventive Medicine Physician in Vail, Colorado. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

2211 N Frontage Rd W
Vail, CO 81657-3937
Phone: (978) 621-4027
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Public Health & General Preventive Medicine Physician (primary) Taxonomy 2083P0901X

Record details

NPI number1154129815
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pamela Shifrin — Owner · (978) 621-4027
NPI enumeratedMarch 6, 2025
Last updated in NPPESMarch 6, 2025
Certification dateMarch 6, 2025
Mailing address2211 N Frontage Rd W, Vail, CO 81657-3937