POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1265048177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265048177 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
2 W 42nd St Ste 2200 Scottsbluff NE 69361-4669 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 3086302626 |
| Practice Fax Number | 3086302636 |
| Mailing Telephone | 3086302626 |
| Mailing Fax Number | 3086302636 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| 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 CV Surgery - Scottsbluff | 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 |
2 W 42ND ST STE 2200 |
| City | SCOTTSBLUFF |
| State | NE |
| Zip Code | 69361-4669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700417391 | Poudre Valley Medical Group, LLC | Internal Medicine | 2 W 42nd St Ste 2200, Scottsbluff, NE 69361-4669 | 2020-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710592803 | Sara Lynn Luehrs | Counselor | Westmoor Elementary, Scottsbluff Public Schools, 1722 Avenue K, Scottsbluff, NE 69361 | 2020-09-15 |
| 1467924076 | Kelly Jean Betts | Nurse Practitioner | 1601 W. 27th St., Wncc Harms Building, Scottsbluff, NE 69361 | 2018-12-20 |
| 1952824716 | Ellen Otto | Nurse Practitioner | 3210 Ave B, Suite B Quick Care, Scottsbluff, NE 69361 | 2017-07-24 |
| 1518379593 | Suzanne Poynter | Counselor | 14 West 27th, Suite 26, Scottsbluff, NE 69361 | 2014-05-27 |
| 1770834970 | Gabrielle K Mickelson | Dental Hygienist | 204 W 36th St, Scottsbluff, NE 69361 | 2012-09-27 |
| 1225393390 | Brittany R Eirich | Internal Medicine | 3911 Ave B Ste #1100, Scottsbluff, NE 69361 | 2012-07-05 |
| 1548560584 | Western Plains Psychology P.C. | Psychologist | 3911 Ave B, Suite 3400, South Plaza, Scottsbluff, NE 69361 | 2010-10-25 |
| 1033340146 | Bluffs Health Care Clinic | Physician Assistant | 914 W 36th Str, Scottsbluff, NE 69361 | 2009-08-06 |
| 1598972994 | Panhandle Mental Health Center | Case Management | 410 South Beltline, Suite 3, Scottsbluff, NE 69361 | 2007-05-16 |
| 1821201294 | Kay C. Gamet | Social Worker | 4410 Ave D, Scottsbluff, NE 69361 | 2007-05-08 |
| Find all providers in zip 69361 | ||||
| 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 |
|---|---|---|---|---|
| 1013275254 | Stephen Walker Carveth | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 6200 Black Forest Dr, Lincoln, NE 68516-2392 | 2012-04-25 |
| 1992883599 | Robert A. Oakes | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1500 S 48th St Ste 400, Lincoln, NE 68506-1278 | 2006-11-01 |
| 1831279132 | Michael C Bibler | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3015 A Ave, Kearney, NE 68847-3587 | 2006-10-17 |
| 1679573877 | William H Fleming | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 17850 S Reflection Ave, Bennington, NE 68007-5727 | 2005-07-28 |
| 1245742451 | Marian Urban | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Emile @ 42nd St, Omaha, NE 68198-0001 | 2017-10-27 |
| 1487175261 | Jill R Nohl | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Emile 42nd St, Omaha, NE 68198-0001 | 2017-06-30 |
| 1619390465 | Ashley Fratello | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 7440 S 91st St, Lincoln, NE 68526-9797 | 2014-01-30 |
| 1275832537 | David Benjamin Berkheim | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 505 S. 48th St, Omaha, NE 68198 | 2011-03-24 |
| 1356665392 | Adam Michael Kingston | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1120 N 103rd Plz Ste 100, Omaha, NE 68114-1119 | 2010-03-19 |
| 1942531033 | Heart Surgery PC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4242 Farnam St, #355, Omaha, NE 68131-2806 | 2010-01-29 |
| Find all providers with the same taxonomy | ||||
| City | SCOTTSBLUFF |
| Zip Code | 69361 |
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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.