POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1437780020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437780020 |
Entity Type | Organization |
Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
Practice Address |
1313 S St Bridgeport NE 69336-2563 |
Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
Practice Telephone | 3082621616 |
Practice Fax Number | 3082621529 |
Mailing Telephone | 3082621616 |
Mailing Fax Number | 3082621529 |
Enumeration Date | 2020-02-01 |
Last Update Date | 2020-02-01 |
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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
UCHealth Heart and Vascular Clinic - Bridgeport | 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 |
1313 S ST |
City | BRIDGEPORT |
State | NE |
Zip Code | 69336-2563 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730109075 | Morrill County Community Hospital | Clinic/Center | 1313 S St, Ste A, Bridgeport, NE 69336-2563 | 2006-07-20 |
1730720533 | Kimberly R Smith | Nurse Practitioner | 1313 S St, Bridgeport, NE 69336-2563 | 2019-10-02 |
1821647611 | Melody J Leisy | Nurse Practitioner | 1313 S St, Bridgeport, NE 69336-2563 | 2019-09-05 |
1568820900 | Amber E Malcolm | Nurse Practitioner | 1313 S St, Bridgeport, NE 69336-2563 | 2016-01-31 |
1639583321 | Mansoor Ahmad | Family Medicine | 1313 S St, Bridgeport, NE 69336-2563 | 2014-06-20 |
1639449333 | Carrie C Martinson | Specialist | 1313 S St, Bridgeport, NE 69336-0579 | 2012-01-11 |
1396961645 | Morrill County Community Hospital | Internal Medicine | 1313 S St, Ste A, Bridgeport, NE 69336-2563 | 2007-04-17 |
1740399468 | Diane E. Gilles | Orthopaedic Surgery | 1313 S St, Bridgeport, NE 69336-2563 | 2006-08-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477608610 | Alliance Vision Source, P.C. | Optometrist | 921 Main Street, Bridgeport, NE 69336 | 2007-01-25 |
1497816680 | J & J Nein LLC | Pharmacy | 1012 Main St, Bridgeport, NE 69336 | 2006-12-12 |
1790977148 | Shawn Michael Berry | Physical Therapy Assistant | 505 Q St, Heritage of Bridgeport, Bridgeport, NE 69336-0081 | 2007-08-09 |
1093088155 | Amy Dawn Craig | Licensed Practical Nurse | 1014 N St, Bridgeport, NE 69336-0101 | 2012-02-20 |
1154433068 | James David Nein | Pharmacist | 1013 Main St, Bridgeport, NE 69336-0141 | 2006-08-31 |
1356420806 | Christensen Chiropractic Clinic, P.C. | Clinic/Center | 805 Main Street, Bridgeport, NE 69336-0759 | 2006-11-03 |
1184835183 | Sam F. Jacoby | Dentist | 1006 Main Street, Bridgeport, NE 69336-0864 | 2007-05-24 |
1003260126 | Lisa Lussetto | Speech-Language Pathologist | 800 Q St, Bridgeport, NE 69336-2519 | 2016-04-14 |
1114572377 | Brittany Beth Norman | Registered Nurse | 800 Q St, Bridgeport, NE 69336-2519 | 2019-08-05 |
1356821276 | Sarah Nicole Brenner | Physical Therapist | 800 Q St, Bridgeport, NE 69336-2519 | 2018-08-20 |
Find all providers in zip 69336 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
---|---|---|---|---|
1043713456 | United Hospital Center, Inc. | Internal Medicine | 527 Medical Park Dr Ste 106, Bridgeport, WV 26330-9009 | 2018-03-12 |
1033367743 | Mobile Cv Imaging, LLC | Internal Medicine | 136 Grovers Ave, Bridgeport, CT 06605-3536 | 2008-09-05 |
1073680393 | Abdul Rahim Khan | Internal Medicine | 285 Anton Dr, Bridgeport, CT 06606-1748 | 2006-11-30 |
1376595702 | David H Church | Internal Medicine | 527 Medical Park Dr Ste 304, Bridgeport, WV 26330 | 2006-05-16 |
1760440663 | Harry Bishop | Internal Medicine | 147 W Main St, Bridgeport, WV 26330-1866 | 2006-05-02 |
1598761512 | Joseph A Rose | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4252 | 2005-06-23 |
1144731464 | Heart Health Clinic Pllc | Internal Medicine | 808 Woodrow Wilson Ray Cir, Bridgeport, TX 76426-2061 | 2017-10-13 |
1750768149 | Clarksburg Cardiovascular Pllc | Internal Medicine | 527 Medical Park Dr, Ste 306-a, Bridgeport, WV 26330-9008 | 2015-05-05 |
1699909432 | Anja Wagner | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4284 | 2009-05-07 |
1578726956 | Cardiology Physicians, P.C. | Internal Medicine | 4675 Main St, Bridgeport, CT 06606-1813 | 2008-07-07 |
Find all providers in BRIDGEPORT |
City | BRIDGEPORT |
Zip Code | 69336 |
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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.