POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1679188759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679188759 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
6767 29th St Fl 2 Greeley CO 80634-5474 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9706522491 |
| Practice Fax Number | 9706522492 |
| Mailing Telephone | 9706522491 |
| Mailing Fax Number | 9706522492 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| 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 | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Urology 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 |
6767 29TH ST FL 2 |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-5474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180551 | Daniel Henry Monkowski | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2005-11-10 |
| 1952916587 | Poudre Valley Medical Group, LLC | Surgery | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-09-10 |
| 1770196990 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-08-27 |
| 1154934388 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-08-27 |
| 1023626157 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-07-15 |
| 1053933168 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-05-12 |
| 1285256388 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-05-12 |
| 1376162206 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-04-10 |
| 1598296949 | Rachel Slick | Social Worker | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2017-03-27 |
| 1699180364 | Caren Millard | Surgery | 6767 29th St Fl 2, Greeley, CO 80634 | 2014-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707843 | Witting Medical, LLC | Pathology | 17 Dos Rios, Greeley, CO 80634 | 2020-07-15 |
| 1730706102 | Heart Centered Counseling | Counselor | 1770 W 25th Street #206, Greeley, CO 80634 | 2020-07-01 |
| 1396374237 | Kidstuff Child and Family Counseling, P.C. | Counselor | 1770 25th Ave., Ste. 102, Greeley, CO 80634 | 2020-04-03 |
| 1164055745 | Stephanie Alexis Balunda | Speech-Language Pathologist | Uchealth Physical Therapy and Rehabilitation Clinic, 6767 West 29th St., Greeley, CO 80634 | 2020-02-21 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1043797749 | Burt Stewart Dmd Pllc | Clinic/Center | 6937 West 10th Street, Greeley, CO 80634 | 2018-07-25 |
| 1164913885 | Innovations Pediatric Therapy, LLC | Occupational Therapist | 3403 W 7th St Apt A, Greeley, CO 80634 | 2018-05-29 |
| 1003305319 | Austin Michael Lake | Physical Therapist | 4681 W 20th St Unit 202b, Greeley, CO 80634 | 2018-05-02 |
| 1225542004 | Kevin Lichner | Specialist/Technologist | 522 28th Ave, Greeley, CO 80634 | 2017-11-30 |
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| Find all providers in zip 80634 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881644532 | Curtis E Crylen | Urology | 5890 W 13th Street, Suite 106, Greeley, CO 80634-4821 | 2006-05-12 |
| 1073956942 | Jason Warncke | Urology | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2013-04-10 |
| 1780829895 | Arlene E. Maurice | Urology | 2001 70th Ave Ste 300, Greeley, CO 80634-4632 | 2008-12-04 |
| 1467604637 | Kevin Michael Clay | Urology | 5881 W 16th St, Suite D, Greeley, CO 80634-2910 | 2008-10-18 |
| 1750573283 | David F Ritsema | Urology | 5890 W 13th St, Suite 106, Greeley, CO 80634-4821 | 2007-08-17 |
| 1043420599 | North Colorado Urology PC | Urology | 5890 W 13th St, Ste 106, Greeley, CO 80634-4821 | 2007-05-23 |
| 1801004197 | Phillip Stephen Kick | Urology | 5881 W 16th St, Greeley, CO 80634-2910 | 2007-05-18 |
| 1881673820 | James William Wolach | Urology | 5890 W 13th St, Suite 106, Greeley, CO 80634-4816 | 2006-01-10 |
| 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 |
| 1619586187 | Poudre Valley Medical Group, LLC | Urology | 175 S Union Blvd Ste 315, Colorado Springs, CO 80910-3126 | 2020-07-30 |
| 1932718418 | Portercare Adventist Health System | Urology | 2352 Meadows Blvd Ste 300u, Castle Rock, CO 80109-8406 | 2020-07-30 |
| 1417566274 | Portercare Adventist Health System | Urology | 9949 S Oswego St Ste 300, Parker, CO 80134-3888 | 2020-07-28 |
| 1255981833 | Advanced Urology, Pllc | Urology | 500 W 144th Ave Ste 220, Westminster, CO 80023-9328 | 2019-09-16 |
| 1316597990 | Advanced Urology, Pllc | Urology | 1411 S Potomac St Ste 210, Aurora, CO 80012-4538 | 2019-09-16 |
| 1629628201 | Advanced Urology, Pllc | Urology | 2030 Mountain View Ave Ste 420, Longmont, CO 80501-3182 | 2019-09-16 |
| 1528618303 | Advanced Urology, Pllc | Urology | 4743 Arapahoe Ave Ste 104, Boulder, CO 80303-1123 | 2019-09-13 |
| 1902463508 | San Juan Regional Medical Center Inc | Urology | 1485 Florida Rd Ste 103a, Durango, CO 81301-6873 | 2019-05-20 |
| 1093207680 | University Physicians Incorporated | Urology | 9330 S University Blvd Ste 230, Highlands Ranch, CO 80126-5049 | 2018-05-31 |
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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.