POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1023623659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023623659 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
2121 E Harmony Rd Unit 330 Fort Collins CO 80528-3403 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9702215878 |
| Practice Fax Number | 9702213564 |
| Mailing Telephone | 9702215878 |
| Mailing Fax Number | 9702213564 |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |
| Authorized Official Name | JANA CONROY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 9706244443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Surgical Clinic - Harmony Campus | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350476 | Poudre Valley Medical Group, LLC | Urology | 2315 E Harmony Rd Ste 140, Fort Collins, CO 80528-8620 | 2020-09-15 |
| 1699389353 | Poudre Valley Medical Group, LLC | Internal Medicine | 5818 N Nevada Ave, Suite 225, Colorado Springs, CO 80918 | 2020-09-01 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1134732209 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 5818 N Nevada Avenue, Suite 225, Colorado Springs, CO 80918 | 2020-08-28 |
| 1104439322 | Poudre Valley Medical Group, LLC | Radiology | 525 Bob Peters Grv Ste 100, Colorado Springs, CO 80909-4533 | 2020-08-27 |
| 1932712155 | Poudre Valley Medical Group, LLC | Internal Medicine | 940 Central Park Dr Ste 290, Steamboat Springs, CO 80487-8853 | 2020-08-27 |
| 1033722376 | Poudre Valley Medical Group, LLC | Family Medicine | 15854 Jackson Creek Pkwy Unit 120, Monument, CO 80132-8663 | 2020-08-26 |
| 1285247866 | Poudre Valley Medical Group, LLC | Physical Therapist | 6767 29th St Fl 1, Greeley, CO 80634-5474 | 2020-08-25 |
| 1932711868 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 100 Cook St Ste 210, Denver, CO 80206-5328 | 2020-08-21 |
| 1619586187 | Poudre Valley Medical Group, LLC | Urology | 175 S Union Blvd Ste 315, Colorado Springs, CO 80910-3126 | 2020-07-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Poudre Valley Medical Group, LLC | 2695 Rocky Mountain Ave., Suite 110, Loveland, CO 80538 |
| Street Address |
2121 E HARMONY RD UNIT 330 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80528-3403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255593851 | Heather Lynn Lewis | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2008-06-26 |
| 1437673787 | Jacob C Smith | Registered Nurse | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2017-07-28 |
| 1083169494 | Kelsey Aliabadi | Registered Nurse | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2016-08-16 |
| 1821493560 | Katelyn Selch | Physician Assistant | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528 | 2014-10-23 |
| 1063705556 | Kaitlin Jane Viola | Physician Assistant | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2011-05-17 |
| 1881983807 | Joshua Walker Kuethe | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2011-03-30 |
| 1750680484 | Christian James Dennis | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2011-03-21 |
| 1316266703 | Rachael Nemcic | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2010-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518475391 | Corinna Kromer | Specialist | 4818 Snowdrift Circle, Fort Collins, CO 80528 | 2018-01-16 |
| 1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
| 1790231413 | Pineridge Healthcare, Inc. | Skilled Nursing Facility | 4880 Ziegler Road, Fort Collins, CO 80528 | 2016-09-01 |
| 1750647244 | Annika Svea Kamberelis | Physician Assistant | 2121 E Harmony Rd Unit 300, Fort Collins, CO 80528 | 2012-04-09 |
| 1831481944 | Natasha E. Walter-fisk | Counselor | 5225 White Willow Dr. M220, Fort Collins, CO 80528 | 2011-05-07 |
| 1629216627 | Augusto Miravalle | Psychiatry & Neurology | 2121 E. Harmony Road, Suite 180, Ft Collins, CO 80528 | 2009-01-29 |
| 1114100252 | Alicia R. Young | Psychologist | 8010 S Country Road 5, Suite 201, Windsor, CO 80528 | 2007-12-12 |
| 1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
| 1437368578 | Shelley M Oliver | Orthopaedic Surgery | 2121 E. Harmony Rd. Ste 290, Fort Collins, CO 80528 | 2007-05-22 |
| 1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
| Find all providers in zip 80528 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467069120 | Colorado Medical Group, Pllc | Surgery | 3665 John F Kennedy Pkwy Ste 200, Fort Collins, CO 80525-3152 | 2020-09-28 |
| 1255593851 | Heather Lynn Lewis | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2008-06-26 |
| 1245334762 | Charles F. Bellows IIi | Surgery | 3665 John F Kennedy Pkwy Ste 1-200, Fort Collins, CO 80525-3152 | 2006-09-13 |
| 1962454223 | Christine Schaefer | Surgery | 222 Jackson Ave, Fort Collins, CO 80521-2445 | 2006-05-16 |
| 1285628396 | Richard A Hohm | Surgery | 1217 Riverside Ave, Fort Collins, CO 80524-3218 | 2005-09-02 |
| 1083613582 | Steven Lewis Kaufman | Surgery | 1136 East Stuart St., Suite 4102, Fort Collins, CO 80525 | 2005-07-18 |
| 1538774864 | Poudre Valley Medical Group, LLC | Surgery | 2121 E Harmony Rd Unit 250, Fort Collins, CO 80528-3402 | 2020-09-14 |
| 1881983807 | Joshua Walker Kuethe | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2011-03-30 |
| 1316266703 | Rachael Nemcic | Surgery | 2121 E Harmony Rd Unit 330, Fort Collins, CO 80528-3403 | 2010-05-25 |
| 1376780544 | Bain-bauling Company Pllc | Surgery | 1025 Garfield St, Ste B, Fort Collins, CO 80524-3930 | 2009-01-09 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80528 |
Please comment or provide details below to improve the information on POUDRE VALLEY MEDICAL GROUP, LLC.
| 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.