POUDRE VALLEY MEDICAL GROUP, LLC


Address: 1850 Mountain View Ave, Longmont, CO 80501-3212
Phone: 7204943118

POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1477182640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477182640
Entity Type Organization
Organization Name POUDRE VALLEY MEDICAL GROUP, LLC
Practice Address 1850 Mountain View Ave
Longmont
CO 80501-3212
Mailing Address 2695 Rocky Mountain Ave Ste 150
Loveland
CO 80538-9071
Practice Telephone 7204943118
Practice Fax Number 7202378035
Mailing Telephone 7204943118
Mailing Fax Number 7202378035
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
UCHealth Dermatology Clinic - Longmont Other Name - Individual/Organization

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Poudre Valley Medical Group, LLC 2695 Rocky Mountain Ave., Suite 110, Loveland, CO 80538

Office Location

Street Address 1850 MOUNTAIN VIEW AVE
City LONGMONT
State CO
Zip Code 80501-3212

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801930110 Isabel Koelsch Dermatology 1850 Mountain View Ave, Longmont, CO 80501-3212 2007-02-19
1396183356 Alycia Carey Barland Internal Medicine 1850 Mountain View Ave, Longmont, CO 80501-3212 2013-06-11
1730523531 Jessica N Doty Dermatology 1850 Mountain View Ave, Longmont, CO 80501-3212 2013-04-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598376774 Boulder County Public Health Public Health or Welfare 515 Coffman Street, Suite 200, Longmont, CO 80501 2020-08-12
1164032827 Kidstuff Child and Family Counseling, P.C. Marriage & Family Therapist 360 15th Ave, Ste. 104, Longmont, CO 80501 2020-08-06
1861036501 Stateserv Medical of Colorado Durable Medical Equipment & Medical Supplies 63 South Pratt Pkwy, Landmont, CO 80501 2019-11-06
1558915090 Array Clinical and Therapeutic Services Assistant Behavior Analyst 451 21st Ave. Suite B, Longmont, CO 80501 2019-08-01
1275195042 Alisa Marie Schwegerl Speech-Language Pathologist 1800 Stroh Place, Longmont, CO 80501 2019-07-02
1295298545 Jovahna Pena Counselor Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 2019-04-12
1659845568 University Physicians Incorporated Advanced Practice Midwife 2030 Mountain View Ave Ste 400, Longmont, CO 80501 2019-01-14
1013404714 Crafted Physical Therapy Pllc Physical Therapist 701 Delaware Ave Unit E, Longmont, CO 80501 2018-04-18
1588110860 Randall Bonnom Counselor 420 21st Ave #113, Longmont, CO 80501 2016-08-28
1225401771 Sowash Optometry Group, PC Eyewear Supplier (Equipment, not the service) 1242 S. Hover Street, Suite C200, Longmont, CO 80501 2015-11-05
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558853846 Crossroads Dermatology LLC Dermatology 2350 17th Ave Ste 100, Longmont, CO 80503-1738 2018-06-01
1801930110 Isabel Koelsch Dermatology 1850 Mountain View Ave, Longmont, CO 80501-3212 2007-02-19
1134299282 Isabel H Koelsch Md Dermatology 1850 W Mountain View Ave, Longmont, CO 80501 2006-11-08
1023000692 John Christopher Fueston Dermatology 205 S Main St, Suite E, Longmont, CO 80501-1716 2005-08-18
1730523531 Jessica N Doty Dermatology 1850 Mountain View Ave, Longmont, CO 80501-3212 2013-04-23
1467628404 Twin Peaks Dermatology, PC Dermatology 205 S Main St, Suite E, Longmont, CO 80501-1716 2008-04-30
1013900539 Kristin M Baird Dermatology 1551 Professional Ln, Suite 135, Longmont, CO 80501-6972 2005-08-30
1992702161 Peter Bachmann Dermatology 1925 Mountain View Ave, Longmont, CO 80501-3128 2005-07-03
1366447740 Scott Clark Dermatology 1925 W Mountain View Ave, Longmont, CO 80501-3128 2005-06-14

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1720685894 Colorado Springs Dermatology Clinic, P.C. Dermatology 1332 Bauer Ln, Canon City, CO 81212-4669 2020-10-02
1891392973 Colorado Springs Dermatology Clinic, P.C. Dermatology 2060 Briargate Pkwy Ste 150, Colorado Springs, CO 80920-7660 2020-10-02
1033723465 Inspired Dermatology, Pllc Dermatology 6050 Greenwood Plaza Blvd Ste 130, Greenwood Village, CO 80111-4823 2020-09-02
1700496668 Sorkin Dermatology Associates Professional LLC Dermatology 1960 N. Ogden Street, Suite 555, Denver, CO 80218-3602 2020-08-05
1194340802 Epiphany Dermatology of Colorado, LLC Dermatology 2530 N 8th St Ste 205, Grand Junction, CO 81501-8858 2020-06-09
1861026189 University Physicians Incorporated Dermatology 14305 E Alameda Ave Ste 225, Aurora, CO 80012-2549 2020-02-25
1316577323 Medical Man Cave Pllc Dermatology 250 Steele Street, Suite 350, Denver, CO 80206-5242 2020-01-17
1124664248 Allison Marquis Dermatology 4350 Limelight Ave Ste 205, Castle Rock, CO 80109-8034 2019-11-24
1790255313 Core Dermatology, Pllc Dermatology 425 South Cherry Suite 907, Glendale, CO 80246 2018-11-26
1326521576 Kaitlyn Laurel Pell Dermatology 125 Inverness Dr E Ste 340, Englewood, CO 80112-5139 2018-09-13
Find all providers with the same taxonomy

Competitor

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City LONGMONT
Zip Code 80501

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Dataset Information

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.

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