POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1467081612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467081612 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
555 Prospect Ave Estes Park CO 80517-6312 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9702377700 |
| Mailing Telephone | 9702377700 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| 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 | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Cancer Care and Hematology Clinic - Estes 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 |
555 PROSPECT AVE |
| City | ESTES PARK |
| State | CO |
| Zip Code | 80517-6312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770584336 | Michael Prochoda Md PC | Ophthalmology | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2005-08-04 |
| 1265033138 | Lake Loveland Dermatology PC | Dermatology | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2020-11-05 |
| 1316552474 | Poudre Valley Medical Group, LLC | Urology | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2020-09-14 |
| 1134732357 | Poudre Valley Medical Group, LLC | Internal Medicine | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2020-08-27 |
| 1760001382 | Poudre Valley Medical Group, LLC | Internal Medicine | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2020-04-14 |
| 1356901649 | Park Hospital District | Home Health | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2019-06-18 |
| 1669776373 | Shanda Mariel Gomes | Emergency Medicine | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2011-01-10 |
| 1326366238 | John J Meyer | Emergency Medicine | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2010-05-17 |
| 1285869263 | Ingra R Marske | Physician Assistant | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2009-05-20 |
| 1689835365 | Robyn A Zehr | Family Medicine | 555 Prospect Ave, Estes Park, CO 80517-6312 | 2008-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346863123 | Action Potential Health and Wellness | Counselor | 157 W Elkhorn Ave, Estes Park, CO 80517 | 2020-05-27 |
| 1861959355 | Dr. Kenneth J. Mcdonald, Psy.d., LLC | Clinic/Center | 356 East Elkhorn Ave., Estes Park, CO 80517 | 2019-02-21 |
| 1992274856 | Park Hospital District | Clinic/Center | 420 Steamer Drive, Estes Park, CO 80517 | 2018-11-20 |
| 1912353145 | Deedra Ivie | Counselor | 880 Macgregor Ave., Estes Park, CO 80517 | 2016-05-06 |
| 1487029112 | Brandon Angus | Dentist | 131 Stanley Ave Ste 201, Estes Park, CO 80517 | 2015-12-07 |
| 1013284199 | Aspen Grove Counseling, LLC | Counselor | 356 E Elkhorn Ave, Suite 9, Estes Park, CO 80517 | 2011-11-17 |
| 1114227758 | Susan Jane Steele | Acupuncturist | 349 Mountain Ave, Berthoud, CO 80517 | 2010-10-29 |
| 1962716613 | Wendy Sarutzki | Acupuncturist | 191 West Riverside Drive, Unit B, Estes Park, CO 80517 | 2010-08-04 |
| 1518156918 | Lynn A. Harris, Psy.d., P.C. | Psychologist | 356 East Elkhorn Ave, Estes Park, CO 80517 | 2007-10-22 |
| 1821201856 | Cynthia Sisson | Physical Therapist | 555 Prospect Avenue, Estes Park, CO 80517 | 2007-05-07 |
| Find all providers in zip 80517 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184238578 | Scl Health Medical Group - Denver, LLC | Internal Medicine | 340 Exempla Cir, Lafayette, CO 80026-3384 | 2020-09-02 |
| 1285242636 | Rocky Mountain Cancer Centers LLP | Internal Medicine | 10107 Ridgegate Pkwy Ste 300, Lone Tree, CO 80124-5642 | 2020-07-21 |
| 1356965529 | Platte Valley Medical Group, LLC | Internal Medicine | 1606 Prairie Center Pkwy Ste 270, Brighton, CO 80601-4005 | 2020-06-03 |
| 1457980617 | Poudre Valley Medical Group, LLC | Internal Medicine | 4050 Briargate Pkwy Ste C1100, Colorado Springs, CO 80920-7815 | 2020-04-08 |
| 1407351950 | University Physicians Incorporated | Internal Medicine | 13199 E Montview Blvd Ste 100, Aurora, CO 80045-7202 | 2018-03-27 |
| 1114439924 | Cancer Centers of Colorado, LLC | Internal Medicine | 1601 Lowell Blvd Ste 150, Denver, CO 80204-1545 | 2017-11-02 |
| 1760814644 | Cccric LLC | Internal Medicine | 799 E Hampden Ave Ste 500, Englewood, CO 80113-2777 | 2013-08-02 |
| 1336482769 | Tejas Patil | Internal Medicine | 12801 E 17th Ave Fl 81018, Aurora, CO 80045-2530 | 2013-04-04 |
| 1851667596 | Michelle A Levy | Internal Medicine | 1800 N Williams St Ste 200, Denver, CO 80218-1237 | 2012-03-27 |
| 1790818425 | Western Hematology Oncology Associates, P.C. | Internal Medicine | 34 Van Gordon St, Suite 160, Lakewood, CO 80228-1705 | 2007-03-13 |
| Find all providers with the same taxonomy | ||||
| City | ESTES PARK |
| Zip Code | 80517 |
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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.