POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1366763260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366763260 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Other Organization Name | UCHEALTH MEDICAL GROUP |
| Practice Address |
2695 Rocky Mountain Ave Suite 150 Loveland CO 80538-8702 |
| Practice Telephone | 9706244420 |
| Practice Fax Number | 9706244459 |
| Mailing Telephone | 9706244420 |
| Mailing Fax Number | 9706244459 |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2019-11-19 |
| Authorized Official Name | JANA CONROY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 9706244443 |
| Authorized Official Credential | RHIA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 69906874 | 05 | |
| WY | CLIA PVMG CHEYENNE MEDICAL SPECIALISTS | 53D0519664 | 01 |
| WY | 130638300 | 05 | |
| NE | 10025926100 | 05 | |
| AZ | 674844 | 05 |
| Other Name | Type Code |
|---|---|
| UCHealth Medical Group | Doing Business As Name - 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 |
2695 ROCKY MOUNTAIN AVE SUITE 150 |
| City | LOVELAND |
| State | CO |
| Zip Code | 80538-8702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649277807 | Lawrence A Meredith | Psychiatry & Neurology | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2005-07-03 |
| 1255748034 | Bradley J Martin | Physician Assistant | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2014-07-14 |
| 1891017190 | Arden Mahaffey | Physical Medicine & Rehabilitation | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2010-02-27 |
| 1316114135 | Nathan Denny Swartz | Physical Medicine & Rehabilitation | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2008-05-12 |
| 1205965126 | Katie Marie Weatherhogg | Physical Medicine & Rehabilitation | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2007-03-05 |
| 1033283098 | Robert Burke | Specialist | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2006-11-20 |
| 1285645986 | Sheri J Friedman | Psychiatry & Neurology | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2006-08-10 |
| 1710926746 | Daniel R Wilson | Physical Medicine & Rehabilitation | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2006-06-05 |
| 1568416493 | Joseph P Jacob | Physical Medicine & Rehabilitation | 2695 Rocky Mountain Ave, Suite 200, Loveland, CO 80538-8702 | 2006-05-22 |
| 1285612069 | Austin G Bailey Jr. | Family Medicine | 2695 Rocky Mountain Ave, Ste 110, Loveland, CO 80538-8702 | 2006-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295332385 | Jocelyn Stott | Social Worker | 1611 N Estrella Avenue, Loveland, CO 80538 | 2020-10-02 |
| 1184234049 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 383 W. 37th St., Ste. 104, Loveland, CO 80538 | 2020-08-05 |
| 1578102752 | Shela Wagner | Student in an Organized Health Care Education/Training Program | 2603 North Monroe Ave, Loveland, CO 80538 | 2020-01-05 |
| 1184261901 | Sierra Compton | Behavior Technician | 2906 Ginnala Drive, Loveland, CO 80538 | 2019-12-01 |
| 1497306138 | Warrior Diagnostics, Inc. | Clinical Medical Laboratory | 6215 Aviation Cir., Loveland, CO 80538 | 2019-09-24 |
| 1093372625 | Kimberly Ann Boogaerts | Behavior Technician | 1437 North Denver Ave Ste 237, Loveland, CO 80538 | 2019-05-20 |
| 1033676101 | Hero Vision of Loveland, LLC | Optometrist | 3515 Mountain Lion Drive, Loveland, CO 80538 | 2019-02-26 |
| 1225509201 | Mbbk Consulting Inc. | Day Training, Developmentally Disabled Services | 4115 Georgetown Drive, Loveland, CO 80538 | 2018-12-17 |
| 1457833808 | Judy A Elliott | Speech-Language Pathologist | 3232 Williamsburg St, Loveland, CO 80538 | 2018-09-02 |
| 1245756584 | Beth Joyce Hale | Counselor | 1440 W.29th, #100, Loveland, CA 80538 | 2017-08-18 |
| Find all providers in zip 80538 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407478456 | Poudre Valley Medical Group, LLC | General Practice | 2500 Rocky Mountain Ave # F1016j, Loveland, CO 80538-9004 | 2020-05-13 |
| 1386263044 | Poudre Valley Medical Group, LLC | General Practice | 3800 Wilson Ave, Loveland, CO 80538-2075 | 2020-04-13 |
| 1164958245 | Pamela Mausner | General Practice | 84 Green Mountain Dr, Loveland, CO 80537-9720 | 2017-05-10 |
| 1821380536 | Injury Claims Evaluations, Inc. | General Practice | 1109 W 5th St, Loveland, CO 80537-5231 | 2011-05-12 |
| 1225356868 | Poudre Valley Medical Group, LLC | General Practice | 2695 Rocky Mountain Ave Ste 110, Loveland, CO 80538-9074 | 2010-05-06 |
| 1952590762 | Deborah Warwick Martin | General Practice | 2524 Frances Dr, Loveland, CO 80537-6966 | 2007-10-17 |
| 1861556995 | Michael A Kreimer | General Practice | 10452 Loveland Madeira Rd, Loveland, OH 45039 | 2006-12-21 |
| 1871115758 | Poudre Valley Medical Group, LLC | General Practice | 2500 Rocky Mountain Ave Ste 2200, Loveland, CO 80538-9004 | 2020-05-13 |
| 1760841977 | Peak Performance Medical, LLC. | General Practice | 10582 Loveland Madeira Rd, Loveland, OH 45140-8962 | 2016-02-16 |
| 1922464742 | Dox4all PC | General Practice | 1635 Foxtrail Dr, Suite 337, Loveland, CO 80538-9086 | 2016-01-08 |
| Find all providers in LOVELAND | ||||
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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.