POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1104133073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104133073 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Other Organization Name | PVMG, PRIMARY CARE, STERLING |
| Practice Address |
620 Iris Dr Sterling CO 80751-4716 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9705227266 |
| Mailing Telephone | 9705227266 |
| Mailing Fax Number | 9705224258 |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2019-12-20 |
| Authorized Official Name | JANA CONROY (MANAGER CREDENTIALING) |
| Authorized Official Telephone | 9706244443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PVMG, Primary Care, Sterling | Other Name - Individual/Organization |
| UCHealth Primary Care - Sterling | Doing Business As Name - 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 |
| 1053930115 | Poudre Valley Medical Group, LLC | Otolaryngology | 620 Iris Dr, Sterling, CO 80751-4716 | 2020-04-09 |
| 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 |
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376155648 | Mosaic Md, Pllc | Internal Medicine | 22365 Broderick Dr Ste 330, Sterling, VA 20166-9361 | 2020-08-18 |
| 1881080166 | Munira Shodikulova | Internal Medicine | 20935 Sandian Ter, Sterling, VA 20165-5859 | 2015-04-13 |
| 1235475682 | Etnacare, LLC | Internal Medicine | 45800 Jona Dr, Sterling, VA 20165-5685 | 2012-12-12 |
| 1093072951 | Noor Dabaie | Internal Medicine | 216 E Juniper Ave, Sterling, VA 20164-2416 | 2012-04-17 |
| 1730299926 | Vincent J. Racanelli | Internal Medicine | 101 E. Miller Road, Sterling, IL 61081-3619 | 2006-08-30 |
| 1346253002 | Arvinder Chawla | Internal Medicine | 21495 Ridgetop Circle, Suite 102, Sterling, VA 20166-6512 | 2006-08-14 |
| 1861442758 | Ann Mecherikunnel | Internal Medicine | 107 E Holly Ave, #3, Sterling, VA 20164-5405 | 2006-05-11 |
| 1295797843 | Judith Lim Greco | Internal Medicine | 46440 Benedict Dr Ste 107, Sterling, VA 20164-6602 | 2006-04-06 |
| 1487613410 | Katie Del Pierro | Internal Medicine | 46175 Westlake Dr Ste 440, Sterling, VA 20165-5886 | 2006-03-20 |
| 1437121910 | Rahel G Yirga | Internal Medicine | 20 Pidgeon Hill Dr Ste 208, Sterling, VA 20165-6134 | 2006-02-07 |
| Find all providers in STERLING | ||||
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.