POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1295354801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295354801 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
410 Benedicta Ave Trinidad CO 81082-2005 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9706244443 |
| Mailing Telephone | 9706244443 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth General and Vascular Surgery Clinic - Trinidad | 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 |
410 BENEDICTA AVE |
| City | TRINIDAD |
| State | CO |
| Zip Code | 81082-2005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184616740 | Trinidad Area Health Association | General Acute Care Hospital | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2005-08-19 |
| 1225664485 | Summer Faris | Registered Nurse | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2020-03-19 |
| 1063911832 | Teresa Darlene Coombs | Registered Nurse | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2018-02-07 |
| 1528462975 | Dario Byung San Roman | Registered Nurse | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2014-10-14 |
| 1912349754 | Insight Radiology PC | Radiology | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2013-07-22 |
| 1295178978 | Innova Emergency Medical Associates PC | Emergency Medicine | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2013-04-11 |
| 1841556842 | Thomas R Eckler II | Emergency Medicine | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2012-04-04 |
| 1124352620 | Fatima Pina | Dietitian, Registered | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2009-09-30 |
| 1649464439 | Thomas J Carter | General Practice | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2007-09-05 |
| 1316148158 | Jesse Veris Mullins | Physical Therapy Assistant | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2007-05-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509583 | Crossroads' Turning Points, Inc. | Substance Abuse Rehabilitation Facility | 1004 Carbon Place, Trinidad, CO 81082 | 2020-05-14 |
| 1912427030 | Gwyndolyn Suzanne Snyder | Nurse Practitioner | 1112 Grant Ave, Trinidad, CO 81082 | 2017-06-20 |
| 1336273143 | Online Therapy Services Inc. | Speech-Language Pathologist | 207 E Main, Trinidad, CO 81082 | 2007-03-15 |
| 1023119203 | Paul Andreatta D.d.s.p.c. | Dentist | 1723 E. Main St., Trinidad, CO 81082 | 2006-09-26 |
| 1467400309 | Trinidad Area Health Association | Internal Medicine | 400 Benedicta Ave Ste A, Trinidad, CO 81082 | 2006-05-04 |
| 1235651670 | Kevin Patrick Crosby | Counselor | 417 S Indiana Ave, Trinidad, CO 81082 | 2017-07-07 |
| 1174054928 | Brittany Ladonna Jauernig | Chiropractor | 500 San Juan St, Trinidad, CO 81082 | 2017-03-23 |
| 1982142188 | Southern Colorado Developmental Disabilities Services, Inc | Case Manager/Care Coordinator | 415 S Indiana Ave, Trinidad, CO 81082 | 2017-02-08 |
| 1295001071 | James Ashley Ward | Counselor | 417 S Indiana Ave, Trinidad, CO 81082 | 2012-03-27 |
| 1275704694 | Steven David Blohm | Dentist | 209 E Main, Trinidad, CO 81082 | 2008-03-13 |
| Find all providers in zip 81082 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750491049 | Charles Francis Yeagle IIi | Surgery | 400 Benedicta Ave, Suite F, Trinidad, CO 81082-2099 | 2006-08-30 |
| 1952411258 | Charles F Yeagle, Md, PC | Surgery | 400 Benedicta Ave, Suite F, Trinidad, CO 81082-2099 | 2006-08-30 |
| 1639156177 | David R. Reitter | Surgery | 410 Benedicta Ave, Trinidad, CO 81082-2005 | 2005-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831797554 | Lower Valley Hospital Association | Surgery | 401 Kokopelli Blvd Ste 3, -practice Location Npi Only-, Fruita, CO 81521-3308 | 2020-10-14 |
| 1467069120 | Colorado Medical Group, Pllc | Surgery | 3665 John F Kennedy Pkwy Ste 200, Fort Collins, CO 80525-3152 | 2020-09-28 |
| 1295341907 | Colorado Trauma Services PC | Surgery | 500 W 144th Ave Ste 130, Westminster, CO 80023-9326 | 2020-09-17 |
| 1013523729 | Colorado Trauma Services PC | Surgery | 401 Castle Creek Rd Ste 2400, Aspen, CO 81611-1159 | 2020-09-17 |
| 1679185698 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 9005 Grant St Ste 300, Thornton, CO 80229-4384 | 2020-08-20 |
| 1730791740 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 1719 E 19th Ave Ste 1c, Denver, CO 80218-1235 | 2020-08-20 |
| 1689286692 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 1601 E 19th Ave Ste 4550, Denver, CO 80218-1254 | 2020-08-20 |
| 1982216990 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 601 E Hampden Ave Ste 250, Englewood, CO 80113-2781 | 2020-08-20 |
| 1881206803 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 701 E Hampden Ave Ste 210, Englewood, CO 80113-2737 | 2020-08-20 |
| 1598376345 | Healthone Clinic Services-surgical Specialties LLC | Surgery | 9055 W 80th Dr Ste 24, Arvada, CO 80005-2448 | 2020-08-14 |
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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.