POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1174152417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174152417 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
175 S Union Blvd Ste 300 Colorado Springs CO 80910-3126 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193642554 |
| Practice Fax Number | 7193642555 |
| Mailing Telephone | 7193642554 |
| Mailing Fax Number | 7193642555 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| 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 | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Allergy and Immunology Clinic - Printers 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 |
175 S UNION BLVD STE 300 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-3126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629054101 | Dennis A Phelps | Orthopaedic Surgery | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2005-12-16 |
| 1457970238 | Poudre Valley Medical Group, LLC | Internal Medicine | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2020-04-13 |
| 1972966992 | Jeannette Renee Liller | Registered Nurse | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2016-03-29 |
| 1356787436 | Cameron Hurst Siddens | Internal Medicine | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2013-05-16 |
| 1073856001 | Meghan Teresa Rush | Internal Medicine | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2013-03-28 |
| 1003010919 | Peter Daniel Fredericks | Orthopaedic Surgery | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2007-06-13 |
| 1689713398 | John L. Bengfort | Internal Medicine | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2007-02-06 |
| 1609927854 | Valerie J Shereck | Nurse Practitioner | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2007-01-15 |
| 1619942604 | Janet Sue Anderson | Nurse Practitioner | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2006-02-22 |
| 1396715876 | Mindy Siegel | Orthopaedic Surgery | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2006-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528665239 | Asthma & Allergy Associates, PC | Allergy & Immunology | 7608 N Union Blvd Ste 115, Colorado Springs, CO 80920-3886 | 2020-10-06 |
| 1154971661 | Old Colorado City Wellness Pllc | Allergy & Immunology | 2020 W Colorado Ave # 303, Colorado Springs, CO 80904-3882 | 2019-09-17 |
| 1184731721 | Colorado Springs Allergy & Asthma Clinic, PC | Allergy & Immunology | 3425 Austin Bluffs Pkwy, Suite 205, Colorado Springs, CO 80918-5701 | 2006-08-23 |
| 1023125655 | Eric L Caplan | Allergy & Immunology | 3030 N Circle Dr Ste 300, Colorado Springs, CO 80909-1180 | 2006-08-23 |
| 1326154949 | Bonnie B Baswell | Allergy & Immunology | 1235 Lake Plaza Dr Ste 218, Colorado Springs, CO 80906-3556 | 2006-08-23 |
| 1316970577 | Kristine Elle Hembre | Allergy & Immunology | 2925 Professional Pl, Suite # 103, Colorado Springs, CO 80904-8126 | 2006-07-09 |
| 1639137177 | Kendall A Gerdes | Allergy & Immunology | 3525 American Drive, Colorado Springs, CO 80917 | 2006-05-03 |
| 1386632172 | Christopher Michael Webber | Allergy & Immunology | 8585 Criterion Dr, Unit 64170, Colorado Springs, CO 80920 | 2005-10-06 |
| 1346856473 | Poudre Valley Medical Group, LLC | Allergy & Immunology | 5818 N Nevada, Suite 200, Colorado Springs, CO 80918 | 2020-09-23 |
| 1184818478 | Deborah Ann Sweet | Allergy & Immunology | 2925 Professional Pl, Suite 103, Colorado Springs, CO 80904-8126 | 2007-08-30 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
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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.