POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1053930115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053930115 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
620 Iris Dr Sterling CO 80751-4716 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9703132740 |
| Practice Fax Number | 9705224258 |
| Mailing Telephone | 9705224258 |
| Mailing Fax Number | 9703132740 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| 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 | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Ear, Nose and Throat Clinic - Sterling | 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 |
620 IRIS DR |
| City | STERLING |
| State | CO |
| Zip Code | 80751-4716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932105186 | Richard Charles Lamb | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2005-06-22 |
| 1780204800 | Poudre Valley Medical Group, LLC | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2020-04-18 |
| 1235761735 | Nephrology Clinic PC | Clinic/Center | 620 Iris Dr, Sterling, CO 80751-4716 | 2020-02-12 |
| 1104282755 | Nicole M Showalter | Physician Assistant | 620 Iris Dr, Sterling, CO 80751-4716 | 2016-01-12 |
| 1083032817 | Daniel Lambrecht | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2014-03-29 |
| 1215246442 | Dianna Haas | Counselor | 620 Iris Dr, Sterling, CO 80751-4716 | 2010-10-05 |
| 1104133073 | Poudre Valley Medical Group, LLC | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2010-09-13 |
| 1124200696 | High Country Internal Medicine, P.C. | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2007-11-27 |
| 1639398357 | Jeanne Ann Davis | Nurse Practitioner | 620 Iris Dr, Sterling, CO 80751-4716 | 2007-04-24 |
| 1689643900 | Thomas Howard Soper | Internal Medicine | 620 Iris Dr, Sterling, CO 80751-4716 | 2006-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114557915 | Advantage Treatment Centers Inc | Clinic/Center | 12220 Hwy 61, Sterling, CO 80751 | 2020-01-21 |
| 1477018786 | Elizabeth Broadwell | Nurse Practitioner | 12101 Co-61, Sterling, CO 80751 | 2019-01-31 |
| 1396102794 | Jamie Soucie | Counselor | 330 W. Maint St. Ste B, Sterling, CO 80751 | 2016-01-15 |
| 1023487469 | Tappy Health & Wellness, Inc. | Physical Therapist | 309 S Railway St, Sterling, CO 80751 | 2015-09-16 |
| 1033465257 | Patricia Carol Smith | Physical Therapist | 100 Broadway St. Suite 24, Sterling, CO 80751 | 2012-07-25 |
| 1770855900 | Total Renal Care Inc | Clinic/Center | 603 Holly Dr, Sterling, CO 80751 | 2012-02-03 |
| 1609172782 | Keyna I Schlup | Family Medicine | 428 S 2nd St, Sterling, CO 80751 | 2011-02-07 |
| 1871811604 | Alexis Balstad | Obstetrics & Gynecology | 1405 S 8th Ave Suite 105, Sterling, CO 80751 | 2010-05-04 |
| 1770705659 | Donna Bishop Davis | Marriage & Family Therapist | 228 South Third Street, Suite 1, Sterling, CO 80751 | 2007-05-02 |
| 1659406338 | Kimberly Ann Suter | Dentist | 617 W Main Street, Sterling, CO 80751 | 2007-02-22 |
| Find all providers in zip 80751 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619065455 | Michael Gerberi | Otolaryngology | 1002 Greden Shores Dr., Sterling, IL 61081 | 2006-10-10 |
| 1366439390 | Bryan J Kemker | Otolaryngology | 101 E Miller Rd, Sterling, IL 61081 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063027225 | Barry Berlin | Otolaryngology | 1133 14th St Unit 3800, Denver, CO 80202-2277 | 2020-09-14 |
| 1972112472 | Portercare Adventist Health System | Otolaryngology | 9399 Crown Crest Blvd Ste 401, Parker, CO 80138-8540 | 2020-07-30 |
| 1063048528 | Healthone Clinic Services - Otolaryngology Specialists LLC | Otolaryngology | 14100 E Arapahoe Rd Ste 250, Centennial, CO 80112-4028 | 2020-03-17 |
| 1407482144 | Healthone Clinic Services - Otolaryngology Specialists LLC | Otolaryngology | 7180 E Orchard Rd Ste 202, Centennial, CO 80111-1726 | 2020-03-13 |
| 1598128266 | Edward J Hepworth Md PC | Otolaryngology | 3150 E 3rd Ave, Denver, CO 80206-5245 | 2016-03-31 |
| 1467829309 | Pikes Peak Ent | Otolaryngology | 9475 Briar Village Pt Ste 225, Colorado Springs, CO 80920 | 2015-08-26 |
| 1811376593 | Lauren Sowa | Otolaryngology | 12631 E 17th Ave # Ms 205, Aurora, CO 80045-2527 | 2015-05-27 |
| 1417343153 | Ralph Talbot Kendall | Otolaryngology | 3502 Pine Tree Sq, Colorado Springs, CO 80909-6436 | 2015-04-09 |
| 1134513351 | Planet T Hormone Replacement Center | Otolaryngology | 2631 W Colorado Ave, Colorado Springs, CO 80904-3024 | 2015-03-25 |
| 1699039156 | Catholic Health Initiatives Colorado | Otolaryngology | 11700 W 2nd Pl Ste 435, Lakewood, CO 80228-1732 | 2012-06-29 |
| Find all providers with the same taxonomy | ||||
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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.