POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1144833146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144833146 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
6767 29th St Fl 3 Greeley CO 80634-5474 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9704957421 |
| Practice Fax Number | 9702037179 |
| Mailing Telephone | 9704957421 |
| Mailing Fax Number | 9702037179 |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-08-28 |
| 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 | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Brain and Spine Clinic - Greeley | 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 |
6767 29TH ST FL 3 |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-5474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649536723 | Eks Wye Pollock Iv | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2012-04-03 |
| 1255944831 | Poudre Valley Medical Group, LLC | Pediatrics | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-08-25 |
| 1598378176 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-08-25 |
| 1841814613 | Poudre Valley Medical Group, LLC | Preventive Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-06-08 |
| 1649892662 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-13 |
| 1588286678 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-12 |
| 1265054555 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-11 |
| 1235758012 | Poudre Valley Medical Group, LLC | Family Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-04-13 |
| 1336768480 | Poudre Valley Medical Group, LLC | Otolaryngology | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-04-09 |
| 1750910923 | Poudre Valley Medical Group, LLC | Dermatology | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707843 | Witting Medical, LLC | Pathology | 17 Dos Rios, Greeley, CO 80634 | 2020-07-15 |
| 1730706102 | Heart Centered Counseling | Counselor | 1770 W 25th Street #206, Greeley, CO 80634 | 2020-07-01 |
| 1396374237 | Kidstuff Child and Family Counseling, P.C. | Counselor | 1770 25th Ave., Ste. 102, Greeley, CO 80634 | 2020-04-03 |
| 1164055745 | Stephanie Alexis Balunda | Speech-Language Pathologist | Uchealth Physical Therapy and Rehabilitation Clinic, 6767 West 29th St., Greeley, CO 80634 | 2020-02-21 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1043797749 | Burt Stewart Dmd Pllc | Clinic/Center | 6937 West 10th Street, Greeley, CO 80634 | 2018-07-25 |
| 1164913885 | Innovations Pediatric Therapy, LLC | Occupational Therapist | 3403 W 7th St Apt A, Greeley, CO 80634 | 2018-05-29 |
| 1003305319 | Austin Michael Lake | Physical Therapist | 4681 W 20th St Unit 202b, Greeley, CO 80634 | 2018-05-02 |
| 1225542004 | Kevin Lichner | Specialist/Technologist | 522 28th Ave, Greeley, CO 80634 | 2017-11-30 |
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| Find all providers in zip 80634 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730300716 | Beth Ann Gibbons | Neurological Surgery | 1800 15th St Ste 130, Greeley, CO 80631-4595 | 2007-05-01 |
| 1902841562 | Brian H Wieder | Neurological Surgery | 1800 15th St, Ste 130, Greeley, CO 80631-4500 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396358578 | Scl Health Medical Group - Grand Junction, LLC | Neurological Surgery | 350 Market St Unit 1, Basalt, CO 81621-7410 | 2020-08-26 |
| 1154933786 | Neurosurgery One PC | Neurological Surgery | 9695 S Yosemite St Ste 377, Lone Tree, CO 80124-2826 | 2020-08-17 |
| 1477180255 | Healthone Clinic Services - Surgery Neurological LLC | Neurological Surgery | 1721 E 19th Ave Ste 500, Denver, CO 80218-1242 | 2020-03-24 |
| 1497382246 | Neurosurgery One PC | Neurological Surgery | 9397 Crown Crest Blvd Ste 411, Parker, CO 80138-8789 | 2020-03-23 |
| 1013543891 | Scl Health Medical Group - Denver, LLC | Neurological Surgery | 3455 Lutheran Pkwy Ste 285, Wheat Ridge, CO 80033-6034 | 2020-03-12 |
| 1598300790 | Valley View Hospital Association | Neurological Surgery | 0377 Sylvan Lake Rd, Eagle, CO 81631-0129 | 2019-11-12 |
| 1194369926 | Valley View Hospital Association | Neurological Surgery | 350 Market St Unit 200, Basalt, CO 81621-7403 | 2019-11-05 |
| 1326565177 | Fredric M Sonstein Md Mba Pllc | Neurological Surgery | 333 W Hampden Ave Ste 800, Englewood, CO 80110 | 2017-08-23 |
| 1447773601 | Edin Nevzati | Neurological Surgery | 665 Clermont St, Denver, CO 80220-5023 | 2017-07-19 |
| 1306385752 | Resilience Surgical LLC | Neurological Surgery | 99 Inverness Dr E Ste 100, Englewood, CO 80112-5127 | 2017-02-17 |
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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.