POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1386252419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386252419 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
175 S Union Blvd Ste 310 Colorado Springs CO 80910-3126 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193651950 |
| Practice Fax Number | 7193651951 |
| Mailing Telephone | 7193651950 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| 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 | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Orthopedics Clinic - Printers Park | 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 |
175 S UNION BLVD STE 310 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80910-3126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013912963 | Paolo J. Bahr | Family Medicine | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2005-06-16 |
| 1477960748 | Ian Scott | Physician Assistant | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2014-07-17 |
| 1811334147 | Brittney Jergovich | Family Medicine | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2013-05-28 |
| 1215236757 | Ns Monitoring, LLC | Psychiatry & Neurology | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2011-03-23 |
| 1033439963 | John Thomas Allerdice Seddon | Orthopaedic Surgery | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2010-06-02 |
| 1891947099 | Michael A Sciortino | Physician Assistant | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2008-10-21 |
| 1437342748 | Matthew Kluk | Orthopaedic Surgery | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910 | 2007-08-20 |
| 1912107764 | Jason R. Wild | Orthopaedic Surgery | 175 S Union Blvd Ste 310, Colorado Springs, CO 80910-3126 | 2007-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952955403 | Marian Lin Mondy | Social Worker | 2909 Wellshire Blvd., Colorado Springs, CO 80910 | 2019-08-01 |
| 1538727474 | Lisa Morales | Audiologist | 3225 International Cir Ste 102, Colorado Springs, CO 80910 | 2019-06-05 |
| 1134617038 | Paul Gross | Counselor | 411 Lakewood Circle Dr, C-204-b, Colorado Springs, CO 80910 | 2018-04-25 |
| 1821502923 | Kathleen Lubos Ambros-dahilig | Dental Assistant | 2240 Gilpin Ave, Colorado Springs, CO 80910 | 2017-11-28 |
| 1508384793 | Shawn Maul | Registered Nurse | 115 S Parkside, Colorado Springs, CO 80910 | 2017-09-07 |
| 1376910521 | Kelley Elizabeth Smith Bouchard | Nurse Practitioner | 3225 International Circle Suite 220, Colorado Springs, CO 80910 | 2015-08-24 |
| 1619353430 | Dr. Steven Alan Gould Dds PC | Dentist | 2859 E. Fountain Blvd, Colorado Springs, CO 80910 | 2015-08-04 |
| 1881029155 | Francis Hammet | Chiropractor | 411 Lakewood Circle A1104, Colorado Springs, CO 80910 | 2013-09-05 |
| 1447697586 | Mcb Clinical Research Centers, LLC | Psychologist | 110 S. Parkside Drive, Colorado Springs, CO 80910 | 2013-05-30 |
| 1417206723 | Augustus Albert Edwards | Case Manager/Care Coordinator | 115 Parkside Drive, Colorado Springs, CO 80910 | 2012-08-31 |
| Find all providers in zip 80910 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508475278 | Catholic Health Initiatives Colorado | Orthopaedic Surgery | 1263 Lake Plaza Dr Ste 210a, Colorado Springs, CO 80906-3564 | 2020-07-28 |
| 1376985218 | John Hadyn Drabing | Orthopaedic Surgery | 265 Hidden Valley Rd, Colorado Springs, CO 80919-2704 | 2013-07-19 |
| 1225303043 | David Jackson Tennent | Orthopaedic Surgery | 650 Cochrane Circle, Colorado Springs, CO 80913 | 2012-03-12 |
| 1396981387 | Arnold Lorentz Ahnfeldt | Orthopaedic Surgery | 3008 Springlake Cir W, Colorado Springs, CO 80906-3747 | 2008-12-23 |
| 1184752743 | Thomas Harrison Mahony IIi | Orthopaedic Surgery | 6011 E. Woodmen Rd, Suite 120, Colorado Springs, CO 80923 | 2007-03-02 |
| 1225001332 | James Randolph Percy | Orthopaedic Surgery | 5415 Jarman St, Colorado Springs, CO 80906-8210 | 2006-02-09 |
| 1003886334 | Paul B Rahill | Orthopaedic Surgery | 1755 S 8th St, Ste D1, Colorado Springs, CO 80905-7913 | 2006-01-26 |
| 1285614842 | Wallace K Larson | Orthopaedic Surgery | 4105 Briargate Parkway, Suite 300, Colorado Springs, CO 80920-3487 | 2006-01-19 |
| 1629054101 | Dennis A Phelps | Orthopaedic Surgery | 175 S Union Blvd Ste 300, Colorado Springs, CO 80910-3126 | 2005-12-16 |
| 1891779443 | Hendrick Jackson Arnold IIi | Orthopaedic Surgery | 160 W Fillmore St, Colorado Springs, CO 80907-6155 | 2005-12-06 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80910 |
Please comment or provide details below to improve the information on POUDRE VALLEY MEDICAL GROUP, LLC.
| 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.