POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1336761436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336761436 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1900 16th St Greeley CO 80631-5114 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9706522433 |
| Practice Fax Number | 9706522252 |
| Mailing Telephone | 9706522433 |
| Mailing Fax Number | 9706522252 |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |
| 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Internal Medicine - Greeley Midtown | 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 |
1900 16TH ST |
| City | GREELEY |
| State | CO |
| Zip Code | 80631-5114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356349823 | Marcus Reinhardt | Internal Medicine | 1900 16th St, Greeley, CO 80631-5114 | 2005-07-08 |
| 1750905527 | Poudre Valley Medical Group, LLC | Preventive Medicine | 1900 16th St, Greeley, CO 80631-5114 | 2020-06-08 |
| 1134743503 | Obstetrix Medical Group of Colorado, P.C. | Obstetrics & Gynecology | 1900 16th St, Greeley, CO 80631-5114 | 2020-06-02 |
| 1144842261 | Poudre Valley Medical Group, LLC | Internal Medicine | 1900 16th St, Greeley, CO 80631-5114 | 2020-05-12 |
| 1134748742 | Poudre Valley Medical Group, LLC | Internal Medicine | 1900 16th St, Greeley, CO 80631-5114 | 2020-04-14 |
| 1013576370 | Medical Center of The Rockies | Clinic/Center | 1900 16th St, Greeley, CO 80631-5114 | 2019-06-11 |
| 1891250965 | Poudre Valley Medical Group, LLC | Clinic/Center | 1900 16th St, Greeley, CO 80631-5114 | 2019-02-04 |
| 1205357795 | Kelley Stromer | Pharmacist | 1900 16th St, Greeley, CO 80631-5114 | 2017-07-05 |
| 1023560034 | Kathryn Milizio | Physician Assistant | 1900 16th St, Greeley, CO 80631-5114 | 2016-10-26 |
| 1801265350 | Hebah Refaat | Nurse Practitioner | 1900 16th St, Greeley, CO 80631-5114 | 2015-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1649536723 | Eks Wye Pollock Iv | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2012-04-03 |
| 1013113547 | Veronika Panah | Internal Medicine | 2010 16th St Ste A, Greeley, CO 80631-5188 | 2007-06-22 |
| 1780809848 | Judith Raye Anderson | Internal Medicine | 2125 26th Avenue Ct, Greeley, CO 80634-6618 | 2007-04-16 |
| 1437145190 | Danielle Louise Doro | Internal Medicine | 2010 16th St Ste C, Greeley, CO 80631-5188 | 2005-09-27 |
| 1598751570 | Thomas Charles Fisher | Internal Medicine | University of Northern Colorado, Studenthealthcenter Cassidy Hallcampus Box37, Greeley, CO 80639-0001 | 2005-09-23 |
| 1356349823 | Marcus Reinhardt | Internal Medicine | 1900 16th St, Greeley, CO 80631-5114 | 2005-07-08 |
| 1285256388 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-05-12 |
| 1033647896 | Brian J Daily | Internal Medicine | 6767 29th St, Greeley, CO 80634-5474 | 2017-05-24 |
| 1235670712 | Costa Pete Alimonos | Internal Medicine | 1801 16th St, Greeley, CO 80631-5154 | 2017-03-16 |
| 1194107201 | Jessica A Dedecker | Internal Medicine | 1900 16th St, Greeley, CO 80631 | 2015-06-25 |
| Find all providers in GREELEY | ||||
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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.