POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1366058265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366058265 |
Entity Type | Organization |
Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
Practice Address |
4674 Snow Mesa Dr Ste 100 Fort Collins CO 80528-8614 |
Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
Practice Telephone | 9703361500 |
Practice Fax Number | 9703361505 |
Mailing Telephone | 9703361500 |
Mailing Fax Number | 9703361505 |
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 | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
UCHealth Women's Care Clinic - Snow Mesa | 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 |
4674 SNOW MESA DR STE 100 |
City | FORT COLLINS |
State | CO |
Zip Code | 80528-8614 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457376105 | Brian Christo Toshcoff | Psychiatry & Neurology | 4674 Snow Mesa Dr Ste 100, Fort Collins, CO 80528-8614 | 2006-07-13 |
1063034940 | Poudre Valley Medical Group, LLC | Internal Medicine | 4674 Snow Mesa Dr Ste 100, Fort Collins, CO 80528-8614 | 2020-05-13 |
1609300441 | Benjamin Leon | Internal Medicine | 4674 Snow Mesa Dr Ste 100, Fort Collins, CO 80528-8614 | 2017-04-19 |
1689013229 | Livia Selina Tsien | Internal Medicine | 4674 Snow Mesa Dr Ste 100, Fort Collins, CO 80528-8614 | 2013-06-17 |
1831479146 | Cynthia A. Loffler | Nurse Practitioner | 4674 Snow Mesa Dr Ste 100, Fort Collins, CO 80528-8614 | 2011-08-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518475391 | Corinna Kromer | Specialist | 4818 Snowdrift Circle, Fort Collins, CO 80528 | 2018-01-16 |
1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
1790231413 | Pineridge Healthcare, Inc. | Skilled Nursing Facility | 4880 Ziegler Road, Fort Collins, CO 80528 | 2016-09-01 |
1750647244 | Annika Svea Kamberelis | Physician Assistant | 2121 E Harmony Rd Unit 300, Fort Collins, CO 80528 | 2012-04-09 |
1831481944 | Natasha E. Walter-fisk | Counselor | 5225 White Willow Dr. M220, Fort Collins, CO 80528 | 2011-05-07 |
1629216627 | Augusto Miravalle | Psychiatry & Neurology | 2121 E. Harmony Road, Suite 180, Ft Collins, CO 80528 | 2009-01-29 |
1114100252 | Alicia R. Young | Psychologist | 8010 S Country Road 5, Suite 201, Windsor, CO 80528 | 2007-12-12 |
1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
1437368578 | Shelley M Oliver | Orthopaedic Surgery | 2121 E. Harmony Rd. Ste 290, Fort Collins, CO 80528 | 2007-05-22 |
1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
Find all providers in zip 80528 |
Taxonomy Code | 207V00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316328099 | Emilee Kingston Sandsmark | Obstetrics & Gynecology | 1012 Sycamore St, Fort Collins, CO 80521-1847 | 2015-06-17 |
1578581195 | Karen Elaine Hayes | Obstetrics & Gynecology | 1224 E Elizabeth St, Fort Collins, CO 80524-4007 | 2006-07-18 |
1033167192 | Michelle Lynn Tollefson | Obstetrics & Gynecology | 1107 S Lemay Ave Ste 100, Fort Collins, CO 80524-3955 | 2006-05-04 |
1558330266 | Nicole Marie Hannon Roberson | Obstetrics & Gynecology | 1107 S Lemay Avenue, Suite 300, Fort Collins, CO 80524-3955 | 2006-03-15 |
1912971342 | Gary Allen Ludwin | Obstetrics & Gynecology | 1107 S Lemay Ave Ste 300, Fort Collins, CO 80524-3955 | 2006-02-14 |
1417930280 | Suzanne E Saenz | Obstetrics & Gynecology | 2032 Lowe St Unit 103, Fort Collins, CO 80525-5772 | 2005-11-25 |
1720089014 | Philip N. Priebe | Obstetrics & Gynecology | 1107 S Lemay Ave, Suite 300, Fort Collins, CO 80524-3957 | 2005-08-09 |
1437158565 | Jonathan Bradley Stern | Obstetrics & Gynecology | 1107 South Lemay Avenue, Suite 300, Fort Collins, CO 80524-3957 | 2005-07-20 |
1154934875 | A Womans Place LLC | Obstetrics & Gynecology | 2620 E Prospect Rd Ste 160, Fort Collins, CO 80525-9098 | 2020-08-24 |
1356987788 | Planned Parenthood of The Rocky Mountains | Obstetrics & Gynecology | 825 S Shields St, 6 and 7, Fort Collins, CO 80521-3590 | 2019-11-20 |
Find all providers in FORT COLLINS |
City | FORT COLLINS |
Zip Code | 80528 |
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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.