POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1518597137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518597137 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Other Organization Name | UCHEALTH CANCER CARE AND HEMATOLOGY CLINIC - WRAY |
| Practice Address |
1017 W 7th St Wray CO 80758-1420 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9702377700 |
| Mailing Telephone | 9702377700 |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-01-27 |
| 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 - Wray | 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 |
1017 W 7TH ST |
| City | WRAY |
| State | CO |
| Zip Code | 80758-1420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205817855 | Oralee L Ekberg | Obstetrics & Gynecology | 1017 W 7th St, Wray, CO 80758-1420 | 2005-11-10 |
| 1942809777 | Pyper Lea Miller | Dietitian, Registered | 1017 W 7th St, Wray, CO 80758-1420 | 2020-10-22 |
| 1528682267 | Erin Marie Vieselmeyer | Physician Assistant | 1017 W 7th St, Wray, CO 80758-1420 | 2020-05-28 |
| 1902454697 | Madison Harpenau | Occupational Therapist | 1017 W 7th St, Wray, CO 80758-1420 | 2019-08-27 |
| 1194216911 | Donna Marie Roberts | Nurse Practitioner | 1017 W 7th St, Wray, CO 80758-1420 | 2018-05-29 |
| 1225525058 | Michael Patrick Welch | Family Medicine | 1017 W 7th St, Wray, CO 80758-1420 | 2018-04-17 |
| 1508378423 | Nicolas A Mcduffee | Physician Assistant | 1017 W 7th St, Wray, CO 80758-1420 | 2017-11-01 |
| 1720437601 | Hal Richins Jr. | Family Medicine | 1017 W 7th St, Wray, CO 80758-1420 | 2016-06-10 |
| 1467809566 | Emily Rand | Family Medicine | 1017 W 7th St, Wray, CO 80758-1420 | 2016-05-18 |
| 1306185699 | Banner Health Physicians Colorado LLC | Clinic/Center | 1017 W 7th St, Wray, CO 80758-1420 | 2013-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356998413 | Lisa Mae Arkulari | Technician | 537 Ellis Dr., Wray, CO 80758 | 2019-08-23 |
| 1649646134 | Leeann Schroeder | Counselor | 365 W. 2nd, Wray, CO 80758 | 2015-08-19 |
| 1720476369 | Karen Allison | Occupational Therapist | 320 Canyon Ridge Drive, Wray, CO 80758 | 2015-01-06 |
| 1881834521 | Renee Ruhlman | Counselor | 340 Sourth Birch Street, Wray, CO 80758 | 2009-02-20 |
| 1831375336 | Cedardale Health Care Centre, Inc. | Skilled Nursing Facility | 720 Clay Street, Wray, CO 80758 | 2008-01-14 |
| 1093831356 | Mark Mcdonald P.t., P.C. | Physical Therapist | 7th and Main, Wray, CO 80758 | 2007-03-21 |
| 1801986328 | Michael Lawler | Occupational Therapist | 7th Main, Wrac, Wray, CO 80758 | 2006-10-13 |
| 1912486820 | Wray Community District Hospital | Physical Therapist | 700 Main St, Wray, CO 80758 | 2018-08-10 |
| 1518234970 | Melvin Dustin Dunn | Chiropractor | 363 W 2nd St, Wray, CO 80758-1009 | 2011-11-29 |
| 1528208428 | Centennial Mental Health Center | Community/Behavioral Health | 365 W 2nd St, Wray, CO 80758-1009 | 2009-03-05 |
| Find all providers in zip 80758 | ||||
| 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 |
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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.