POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1659993756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659993756 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1675 18th Ave Ste 3 Greeley CO 80631-5151 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9703475780 |
| Practice Fax Number | 9703475797 |
| Mailing Telephone | 9703475780 |
| Mailing Fax Number | 9703475797 |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |
| 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 Integrative Medicine Clinic - Greeley | 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 |
1675 18TH AVE STE 3 |
| City | GREELEY |
| State | CO |
| Zip Code | 80631-5151 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689621195 | Debra A Dewall | Physician Assistant | 1675 18th Ave Ste 3, Greeley, CO 80631 | 2006-05-28 |
| 1922667187 | Poudre Valley Health Care Inc. | Clinic/Center | 1675 18th Ave Ste 3, Greeley, CO 80631-5151 | 2019-06-11 |
| 1326302183 | Erica Bernhardt | Internal Medicine | 1675 18th Ave Ste 3, Greeley, CO 80631 | 2012-06-26 |
| 1275805418 | Mcr Greeley Infusion Pharmacy | Pharmacy | 1675 18th Ave Ste 3, Greeley, CO 80631-5132 | 2012-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395743 | Marcia Martinez | Peer Specialist | 1700 N 17th Ave, Greeley, CO 80631 | 2020-01-14 |
| 1073083036 | Ryan Lawhead | Specialist/Technologist | 270 Alles Dr. D, Butler Hancock Athletic Center, Greeley, CO 80631 | 2018-12-03 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1760902662 | Robert Anthony Rexroad | Counselor | 1300 N. 17th Avenue, Greeley, CO 80631 | 2017-06-21 |
| 1326577750 | Danielle Rodriguez | Psychologist | 1300 N. 17th Ave, Greeley, CO 80631 | 2017-06-08 |
| 1790157865 | Safeway | Pharmacy | 3526 W 10th Street, Greeley, CO 80631 | 2015-10-28 |
| 1245574508 | Jayme L Clapp | Counselor | 1407 8th Ave, Greeley, CO 80631 | 2012-11-26 |
| 1114246006 | Cynthia Melissa Gitler | Emergency Medicine | Banner Health, North Colorado Medical Center, 1601 18th Street, Greenley, CO 80631 | 2010-05-18 |
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1174760011 | Darwin James Hargrave | Counselor | 912 9th Ave., #222, Greeley, CO 80631 | 2009-01-14 |
| Find all providers in zip 80631 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669483657 | Leslie A Leppla | General Practice | 900 14th St, Greeley, CO 80631-4622 | 2006-08-11 |
| 1528046364 | Thomas J Lynch | General Practice | 1900 16th St, Greeley, CO 80631-5114 | 2006-01-03 |
| 1336124700 | Greeley Medical Clinic | General Practice | 1900 16th St, Greeley, CO 80631-5114 | 2005-12-08 |
| 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 | ||||
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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.