POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1114532801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114532801 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
16222 W Us Highway 24 Ste 210 Woodland Park CO 80863-8763 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7196879999 |
| Practice Fax Number | 7196875713 |
| Mailing Telephone | 7196879999 |
| Mailing Fax Number | 7196875713 |
| 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 |
|---|---|---|---|---|---|
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Specialty Care Clinic - Woodland Park | 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 |
16222 W US HIGHWAY 24 STE 210 |
| City | WOODLAND PARK |
| State | CO |
| Zip Code | 80863-8763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679815757 | Jason Aminsharifi | Surgery | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2013-03-26 |
| 1801402706 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-09-17 |
| 1215542519 | Poudre Valley Medical Group, LLC | Surgery | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-09-14 |
| 1669085882 | Poudre Valley Medical Group, LLC | Internal Medicine | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-08-27 |
| 1932728540 | Poudre Valley Medical Group, LLC | Internal Medicine | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-04-14 |
| 1114546009 | Poudre Valley Medical Group, LLC | Otolaryngology | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576867 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 333 North West Street, Woodland Park, CO 80863 | 2020-07-23 |
| 1003461476 | Alive Connections Counseling, LLC | Community/Behavioral Health | 321 West Henrietta Avenue, Office D-8, Woodland Park, CO 80863 | 2019-08-02 |
| 1720630130 | Jennifer Fuller James | Social Worker | 400 W Midland Ave Ste 100h, Woodland Park, CO 80863 | 2019-07-15 |
| 1558861815 | Thrive Primary Care At Woodland Park LLC | Nurse Practitioner | 1067 Us 24, 276, Woodland Park, CO 80863 | 2018-02-13 |
| 1841712080 | Jamie Andersen | Marriage & Family Therapist | 321 W. Henrietta Ave, Suite B, Woodland Park, CO 80863 | 2017-07-10 |
| 1720438492 | Laurie Kim Warchol | Counselor | 321 West Henrietta, Woodland Park, CO 80863 | 2016-06-14 |
| 1255788402 | Colorado Lions Camp Inc | Respite Care | 28541 Highway 67, Wooodand Park, CO 80863 | 2016-05-18 |
| 1619337193 | Ariana Papi | Specialist/Technologist, Other | 16240 W Hwy 24, Woodland Park, CO 80863 | 2016-02-26 |
| 1104281864 | Daybreak-an Adult Day Program | Respite Care | 404 North Highway 67, Woodland Park, CO 80863 | 2015-12-23 |
| 1104281906 | Kingdom Pediatric Therapy | Speech-Language Pathologist | 1067 E Us Hwy, Pmb 72, Woodland Park, CO 80863 | 2015-12-21 |
| Find all providers in zip 80863 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1134738701 | Catholic Health Initiatives Colorado | Internal Medicine | 41 State Highway 67, Woodland Park, CO 80863-5008 | 2020-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604257 | Healthone Heart Care LLC | Internal Medicine | 310 County Rd, Suite 14, Del Norte, CO 81132 | 2020-09-21 |
| 1659987063 | Healthone Heart Care LLC | Internal Medicine | 1444 S Potomac St Ste 310, Aurora, CO 80012-4508 | 2020-09-21 |
| 1225644834 | Healthone Heart Care LLC | Internal Medicine | 1421 S Potomac St Ste 315, Aurora, CO 80012-4512 | 2020-09-18 |
| 1750995247 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 32135 Castle Ct Ste 100a, Evergreen, CO 80439-8005 | 2020-09-02 |
| 1518570977 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 1960 N Ogden St Ste 540a, Denver, CO 80218-3666 | 2020-08-26 |
| 1982213328 | Catholic Health Initiatives Colorado | Internal Medicine | 1000 Granby Park Dr, Granby, CO 80446-0000 | 2020-07-30 |
| 1437768009 | Catholic Health Initiatives Colorado | Internal Medicine | 920 Rush Dr Ste A, Salida, CO 81201-9669 | 2020-07-29 |
| 1437768124 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 3655 Lutheran Pkwy Ste 201, Wheat Ridge, CO 80033-6010 | 2020-07-28 |
| 1952927527 | Platte Valley Medical Group, LLC | Internal Medicine | 1610 Prairie Center Pkwy Ste 2330, Brighton, CO 80601-4003 | 2020-06-19 |
| 1013539113 | Poudre Valley Medical Group, LLC | Internal Medicine | 328 S Bonaventure Ave Ste 2, Trinidad, CO 81082-2086 | 2020-05-12 |
| Find all providers with the same taxonomy | ||||
| City | WOODLAND PARK |
| Zip Code | 80863 |
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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.