POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1396350690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396350690 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4840 Larimer Pkwy Bldg 1 Johnstown CO 80534-9012 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7207458030 |
| Practice Fax Number | 7207458031 |
| Mailing Telephone | 7207458030 |
| Mailing Fax Number | 7207458031 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| 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 | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| UCHealth Ugent Care Clinic - Johnstown | 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 |
4840 LARIMER PKWY BLDG 1 |
| City | JOHNSTOWN |
| State | CO |
| Zip Code | 80534-9012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508055641 | Kristi Lynn Paetzel | Physician Assistant | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2007-10-15 |
| 1699388934 | Poudre Valley Medical Group, LLC | Family Medicine | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2020-08-26 |
| 1336516665 | Brittany Hunter | Physician Assistant | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2015-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790299410 | Bauer Occupational Therapy, LLC | Occupational Therapist | 442 La Costa Ln, Johnstown, CO 80534 | 2017-11-17 |
| 1942698071 | Family Physicians of Greeley, LLP | Family Medicine | 473 Castle Pines Ave, Suite 1, Johnstown, CO 80534 | 2014-12-23 |
| 1376761924 | Steven L Martin | Dentist | 5 N. Parish Ave., Johnstown, CO 80534 | 2007-04-20 |
| 1699896613 | Ashlea Elizabeth Franques | Pediatrics | 4435 Ronald Reagan Blvd, Johnstown, CO 80534 | 2007-04-03 |
| 1720069198 | Kenneth A Pettine | Orthopaedic Surgery | 4795 Larimer Parkway, Johnstown, CO 80534 | 2005-11-10 |
| 1043858251 | Kristen Mcfarland | Physical Therapist | 247 Mountain Avenue, Berthoud, CO 80534 | 2019-12-18 |
| 1841780400 | Colorado Rehabilitation Associates LLC | Physical Medicine & Rehabilitation | 4401 Union St, Johnstown, CO 80534 | 2018-05-18 |
| 1073059523 | Santibanez Aguirre PC | Hospitalist | 4401a Union Street, Johnstown, CO 80534 | 2017-01-09 |
| 1811142524 | 25/34 Plastic Surgery Associates, PC | Specialist | 4450 Union St., Suite 100, Johnstown, CO 80534-0001 | 2008-11-21 |
| 1790794824 | Marc Anthony Masotti | Internal Medicine | 4401a Union St, Johnstown, CO 80534-2800 | 2006-08-07 |
| Find all providers in zip 80534 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
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|---|---|---|---|---|
| 1912290008 | Icare Medical | Clinic/Center | 100 Susan Dr, Johnstown, PA 15905-2826 | 2011-05-23 |
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| 1992304315 | Afterours Inc | Clinic/Center | 101 W Mineral Ave Ste 105, Littleton, CO 80120-4500 | 2020-10-19 |
| 1104436278 | Urgent Care Lakewood Inc | Clinic/Center | 2616 E 120th Ave, Thornton, CO 80233-1412 | 2020-08-04 |
| 1770192502 | Catholic Health Initiatives Colorado | Clinic/Center | 17230 Jackson Creek Pkwy Ste 120, Monument, CO 80132-7302 | 2020-07-28 |
| 1508483413 | Medventures, Pllc | Clinic/Center | 7280 Lagae Rd Ste I, Castle Pines, CO 80108-9454 | 2020-06-26 |
| 1467078014 | Colorado Mountain Medical, LLC | Clinic/Center | 108 S Frontage Rd W Ste 101, Vail, CO 81657-5087 | 2020-06-19 |
| 1801419197 | Catholic Health Initiatives Colorado | Clinic/Center | 5607 Barnes Rd Ste 140, Colorado Springs, CO 80917-1347 | 2020-05-21 |
| 1861024101 | Catholic Health Initiatives Colorado | Clinic/Center | 4943 Hwy 52, Frederick, CO 80514 | 2020-02-05 |
| 1881225514 | Catholic Health Initiatives Colorado | Clinic/Center | 16320 W 64th Ave, Arvada, CO 80007-7415 | 2020-01-31 |
| 1518507375 | Portercare Adventist Health System | Clinic/Center | 7000 E Hampden, Denver, CO 80224 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
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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.