POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1225658057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225658057 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
2315 San Juan Avenue La Junta CO 81050 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193845412 |
| Practice Fax Number | 7193836547 |
| Mailing Telephone | 7193845412 |
| Mailing Fax Number | 7193836547 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Heart and Vascular Clinic - La Junta | 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 |
2315 SAN JUAN AVENUE |
| City | LA JUNTA |
| State | CO |
| Zip Code | 81050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589567 | Southeast Mental Health Services | Clinic/Center | 721 Barnes Ave, La Junta, CO 81050 | 2019-10-09 |
| 1164945127 | Susan Ann Workman | Clinical Nurse Specialist | 13 West Third Street, Room 111, La Junta, CO 81050 | 2017-07-21 |
| 1952774465 | Ryan T Anderson Ddc PC | Clinic/Center | 13 E 4th St., La Junta, CO 81050 | 2015-11-05 |
| 1083086524 | Ryan Taylor Anderson | Dentist | 13 East 4th Street, La Junta, CO 81050 | 2015-10-23 |
| 1902287329 | Shanna Kay Riley | Case Manager/Care Coordinator | 711 Barnes Ave., La Junta, CO 81050 | 2015-06-11 |
| 1548668593 | Joseph Wayne Lee | Licensed Practical Nurse | 1203 Holt Ln, Lajunta, CO 81050 | 2014-12-08 |
| 1730506809 | Down To Earth Dentistry, LLC. | Dentist | 17 W. 4th St., La Junta, CO 81050 | 2014-03-26 |
| 1154668275 | Arkansas Valley Hearing Center, Inc | Hearing Aid Equipment | 408 West 3rd St, La Junta, CO 81050 | 2013-01-09 |
| 1710223698 | Timothy Eugene Kelley | Counselor | 313 West Third Street, Suite 204, La Junta, CO 81050 | 2012-12-20 |
| 1174817605 | Valley Community Counseling Services, LLC | Community/Behavioral Health | 313 W 3rd Street Lincoln Square Professional Building, Suite 204, La Junta, CO 81050 | 2011-06-01 |
| Find all providers in zip 81050 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.