POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1619585312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619585312 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
301 Kendall Dr Lamar CO 81052-3943 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193366790 |
| Practice Fax Number | 7193367026 |
| Mailing Telephone | 7193366790 |
| Mailing Fax Number | 7193367026 |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |
| 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 | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Outreach Clinic - Lamar | 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 |
301 KENDALL DR |
| City | LAMAR |
| State | CO |
| Zip Code | 81052-3943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295727840 | James Bradbury Smith | Surgery | 301 Kendall Dr, Lamar, CO 81052-3943 | 2005-08-19 |
| 1326329137 | Christine Marie Bogardus | Surgery | 301 Kendall Dr, Lamar, CO 81052 | 2011-09-07 |
| 1427232388 | Jessica J Swanson | Surgery | 301 Kendall Dr, Lamar, CO 81052-3943 | 2007-12-27 |
| 1962684837 | Prowers Medical Center | Clinic/Center | 301 Kendall Dr, Lamar, CO 81052-3943 | 2007-12-03 |
| 1205934536 | Joan T Anderson | Physical Therapist | 301 Kendall Dr, Lamar, CO 81052-3943 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952912370 | Tamela Ray Marie Williams | Registered Nurse | 1001 S Main Street, Lamar, CO 81052 | 2020-08-10 |
| 1912557513 | Sabra Perdue | Registered Nurse | 1001 S. Main St, Lamar, CO 81052 | 2019-09-16 |
| 1134687676 | Mary Lou Montez | Licensed Practical Nurse | 3501 S. Main St., Lamar, CO 81052 | 2019-03-04 |
| 1700316593 | Charles Nolan Philpy | Optometrist | 1607 S Main St, Lamar, CO 81052 | 2017-06-14 |
| 1740650431 | Sand and Sage Personal Care Agency | Home Health | 117 West Elm Street, Lamar, CO 81052 | 2015-10-07 |
| 1396152641 | Colorado Plains Home Health LLC | Home Health | 109 W Lee St., #15, Lamar, CO 81052 | 2014-07-18 |
| 1033541362 | Tammie L Clark | Registered Nurse | 1001 South Main, Lamar, CO 81052 | 2013-08-09 |
| 1417200163 | Karen A Loveless | Case Manager/Care Coordinator | 100 Kendall Dr., Lamar, CO 81052 | 2012-10-18 |
| 1366614075 | Lamar Chiropractic | Chiropractor | 103 E Elm St, Lamar, CO 81052 | 2008-04-02 |
| 1740451996 | Gerald A Branes | Dentist | 109 West Lee, No. 5, Lamar, CO 81052 | 2008-03-17 |
| Find all providers in zip 81052 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861459174 | Carolinas Medical Alliance Inc | General Practice | 105 N Railroad Ave, Lamar, SC 29069-9727 | 2006-04-28 |
| 1508193087 | Barton County Memorial Hospital | General Practice | 29 Nw 1st Ln, Lamar, MO 64759-8105 | 2009-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063020923 | Scl Health Medical Group - Denver, LLC | General Practice | 8550 W 38th Ave Ste 320, Wheat Ridge, CO 80033-4300 | 2020-07-16 |
| 1316569387 | Poudre Valley Medical Group, LLC | General Practice | 4050 Briargate Pkwy Fl 4, Colorado Springs, CO 80920-7815 | 2020-05-13 |
| 1407478456 | Poudre Valley Medical Group, LLC | General Practice | 2500 Rocky Mountain Ave # F1016j, Loveland, CO 80538-9004 | 2020-05-13 |
| 1386263044 | Poudre Valley Medical Group, LLC | General Practice | 3800 Wilson Ave, Loveland, CO 80538-2075 | 2020-04-13 |
| 1932728706 | Poudre Valley Medical Group, LLC | General Practice | 256 W Mountain Ave, Fort Collins, CO 80521-2711 | 2020-04-13 |
| 1023637915 | Poudre Valley Medical Group, LLC | General Practice | 1041 Woodward Way, Fort Collins, CO 80524-3468 | 2020-04-11 |
| 1710516950 | Poudre Valley Medical Group, LLC | General Practice | 4380 Ziegler Rd, Fort Collins, CO 80525-9631 | 2020-04-08 |
| 1689208035 | Balance Wellspace LLC | General Practice | 125 Rampart Way Ste 300, Denver, CO 80230-6429 | 2020-02-25 |
| 1215584321 | Belleview Spince and Wellnces Cos LLC | General Practice | 1257 Lake Plaza Dr Ste 105, Colorado Springs, CO 80906-7300 | 2019-08-22 |
| 1497307771 | Pamela Raring Mclaughlin | General Practice | 2275 Homestead Dr, Grand Junction, CO 81505-8306 | 2019-07-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on POUDRE VALLEY MEDICAL GROUP, LLC.
| 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.