POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1083236947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083236947 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4190 E Woodmen Rd Ste 100 Colorado Springs CO 80920-8075 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193651950 |
| Mailing Telephone | 1936519507 |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Neurology Clinic - Woodmen | 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 |
4190 E WOODMEN RD STE 100 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-8075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364638 | Brian E Zable | Internal Medicine | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2005-05-23 |
| 1124633904 | Jessica Johnson | Physician Assistant | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-09-09 |
| 1841803921 | Poudre Valley Medical Group, LLC | Family Medicine | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-08-28 |
| 1134738495 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-07-23 |
| 1538787973 | Pamela C Anderson | Social Worker | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-07-13 |
| 1740807189 | Carly Marie Ham | Physician Assistant | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-07-01 |
| 1215551155 | Holly Catherine Downing | Nurse Practitioner | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-06-06 |
| 1326667981 | Laura Welch | Social Worker | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-04-14 |
| 1992336739 | Kerry Beth Merchant Favara | Counselor | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2020-01-30 |
| 1477034114 | Rachel L Couch | Nurse Practitioner | 4190 E Woodmen Rd Ste 100, Colorado Springs, CO 80920-8075 | 2018-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194340414 | Northstar Neurology of Colorado Springs PC | Psychiatry & Neurology | 3920 N Union Blvd Ste 150, Colorado Springs, CO 80907-1907 | 2020-06-11 |
| 1518478692 | Grabert Health, LLC | Psychiatry & Neurology | 7871 Dutchrock Rd, Colorado Springs, CO 80919-3893 | 2017-10-17 |
| 1265601645 | Patricia A. Fodor, M.d. P.C. | Psychiatry & Neurology | 7606 N. Union, Suite G, Colorado Springs, CO 80920 | 2008-02-29 |
| 1295916989 | Colorado Center for Neuroscience, PC | Psychiatry & Neurology | 1715 N Weber St # 100, Colorado Springs, CO 80907-7524 | 2007-11-21 |
| 1346324746 | Bradley J Davis | Psychiatry & Neurology | 8715 Massey Cir, Colorado Springs, CO 80920-7127 | 2006-10-24 |
| 1255425831 | Cynthea I Blake | Psychiatry & Neurology | 3010 N. Circle Drive Suite 120, Colorado Springs, CO 80209 | 2006-10-03 |
| 1700994423 | Lawrence C Wang | Psychiatry & Neurology | 3245 International Cir Ste 103, Colorado Springs, CO 80910-3152 | 2006-08-25 |
| 1518992155 | Thomas E. Bowser Md Pllc | Psychiatry & Neurology | 8540 Scarborough Drive Ste 390, Colorado Springs, CO 80920-7519 | 2006-07-12 |
| 1356399448 | Kevin R Scott | Psychiatry & Neurology | 1400 E Boulder St Ste 700, Colorado Springs, CO 80909-5533 | 2006-05-04 |
| 1598755092 | Christopher Steven Williams | Psychiatry & Neurology | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2005-10-26 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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.