POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1124658059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124658059 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1000 Rush Dr Salida CO 81201-9627 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7195302200 |
| Mailing Telephone | 7195302200 |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2020-01-20 |
| 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 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Thoracic Surgery - Salida | 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 |
1000 RUSH DR |
| City | SALIDA |
| State | CO |
| Zip Code | 81201-9627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427647 | William R Schroeder | Internal Medicine | 1000 Rush Dr, Salida, CO 81201-9627 | 2005-06-20 |
| 1184224461 | Pikes Peak Nephrology Associates PC | Internal Medicine | 1000 Rush Dr, Salida, CO 81201-9627 | 2020-10-27 |
| 1720617988 | Eduardo Velazco-hernandez | Specialist/Technologist | 1000 Rush Dr, Salida, CO 81201-9627 | 2020-04-08 |
| 1275166019 | Jill Eva Mcqueen | Nurse Practitioner | 1000 Rush Dr, Salida, CO 81201-9627 | 2020-02-20 |
| 1427601848 | Salida Hospital District | Pharmacy | 1000 Rush Dr, Salida, CO 81201-9627 | 2019-07-24 |
| 1023679446 | Christina Alvord Logan | Occupational Therapist | 1000 Rush Dr, Salida, CO 81201-9627 | 2019-06-26 |
| 1740847367 | Teresa Ann Bernhard | Specialist/Technologist | 1000 Rush Dr, Salida, CO 81201-9627 | 2019-05-20 |
| 1487127098 | Walter Hafner | Physical Therapist | 1000 Rush Dr, Salida, CO 81201-9627 | 2019-01-07 |
| 1851879662 | Marissa Starr | Nurse Practitioner | 1000 Rush Dr, Salida, CO 81201-9627 | 2018-08-02 |
| 1174079669 | Devon Moughan-phillips | Dietitian, Registered | 1000 Rush Dr, Salida, CO 81201-9627 | 2016-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699395418 | Helgrit P Howard | Massage Therapist | Myoarts Therapeutic Massage and Bodyworks, 7405 West Hwy 50, Salida, CO 81201 | 2020-04-22 |
| 1922628742 | Tad Howard | Massage Therapist | 7405 West Hwy 50. Myoarts Therapeutic Message and Body, Salida, CO 81201 | 2020-04-22 |
| 1740821289 | Ljcc Services, LLC | Durable Medical Equipment & Medical Supplies | 137 F Street, Salida, CO 81201 | 2019-10-07 |
| 1215451539 | Julie Zavage | Counselor | 111 Vesta Rd., Salida, CO 81201 | 2017-07-28 |
| 1417488776 | Cynthia Love Pursell | Pharmacist | 910 Rush Drive, Salida, CO 81201 | 2017-03-27 |
| 1215487517 | Melissa Hollan | Massage Therapist | 130 W 2nd Street, Suite 5, Salida, CO 81201 | 2016-10-11 |
| 1114371408 | Jamie Allen Baker | Specialist/Technologist | 1215 D. St., Salida, CO 81201 | 2016-04-22 |
| 1386920692 | Emily Anderson | Registered Nurse | 448 East 1st Street, Salida, CO 81201 | 2011-11-01 |
| 1316248529 | Thomas Michael Deyton | Physical Therapist | 305 G Street, Salida, CO 81201 | 2010-11-04 |
| 1598089518 | Iris Jeanette Diaz Cassidy | Massage Therapist | 1548 G Street, #8 La Placita, Salida, CO 81201 | 2010-03-19 |
| Find all providers in zip 81201 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275190 | Healthone Clinic Services - Cardiovascular LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4567 E 9th Ave Ste 670, Denver, CO 80220-3908 | 2020-11-03 |
| 1083228472 | Scl Health Medical Group - Denver, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1960 N Ogden St Ste 540, Denver, CO 80218-3671 | 2020-09-02 |
| 1134762123 | Catholic Health Initiatives Colorado | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 360 Peak One Blvd, Ste 390, Frisco, CO 80443 | 2019-10-22 |
| 1538406814 | Wilson Willard Strong Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2023 Keystone Ranch Rd, Keystone, CO 80435-8386 | 2013-01-07 |
| 1235428848 | James Mault | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 30589 Monarch Ct, Evergreen, CO 80439-9411 | 2011-04-04 |
| 1710208202 | Paul Franklin Eckstein | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 22 West Cheyenne Mountain Blvd, Colorado Springs, CO 80906-4335 | 2010-06-18 |
| 1881929545 | Robert Lynch Hardesty | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9017 Ranch River Cir, Highlands Ranch, CO 80126-5079 | 2009-10-13 |
| 1487863700 | Crystal Joy Erickson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 525 Bob Peters Grv Ste 302, Colorado Springs, CO 80909-4533 | 2007-05-22 |
| 1649483058 | George Pappas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3595 E Long Rd, Greenwood Village, CO 80121-1916 | 2007-05-08 |
| 1538233754 | Jenifer Lynn Marks | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1444 S Potomac St Ste 390, Aurora, CO 80012-4515 | 2006-11-20 |
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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.