POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1700417391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700417391 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
2 W 42nd St Ste 2200 Scottsbluff NE 69361-4669 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 3086302626 |
| Practice Fax Number | 3086302636 |
| Mailing Telephone | 3086302626 |
| Mailing Fax Number | 3086302636 |
| Enumeration Date | 2020-02-01 |
| Last Update Date | 2020-02-01 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Heart and Vascular Clinic - Scottsbluff | 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 |
2 W 42ND ST STE 2200 |
| City | SCOTTSBLUFF |
| State | NE |
| Zip Code | 69361-4669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265048177 | Poudre Valley Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2 W 42nd St Ste 2200, Scottsbluff, NE 69361-4669 | 2020-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710592803 | Sara Lynn Luehrs | Counselor | Westmoor Elementary, Scottsbluff Public Schools, 1722 Avenue K, Scottsbluff, NE 69361 | 2020-09-15 |
| 1467924076 | Kelly Jean Betts | Nurse Practitioner | 1601 W. 27th St., Wncc Harms Building, Scottsbluff, NE 69361 | 2018-12-20 |
| 1952824716 | Ellen Otto | Nurse Practitioner | 3210 Ave B, Suite B Quick Care, Scottsbluff, NE 69361 | 2017-07-24 |
| 1518379593 | Suzanne Poynter | Counselor | 14 West 27th, Suite 26, Scottsbluff, NE 69361 | 2014-05-27 |
| 1770834970 | Gabrielle K Mickelson | Dental Hygienist | 204 W 36th St, Scottsbluff, NE 69361 | 2012-09-27 |
| 1225393390 | Brittany R Eirich | Internal Medicine | 3911 Ave B Ste #1100, Scottsbluff, NE 69361 | 2012-07-05 |
| 1548560584 | Western Plains Psychology P.C. | Psychologist | 3911 Ave B, Suite 3400, South Plaza, Scottsbluff, NE 69361 | 2010-10-25 |
| 1033340146 | Bluffs Health Care Clinic | Physician Assistant | 914 W 36th Str, Scottsbluff, NE 69361 | 2009-08-06 |
| 1598972994 | Panhandle Mental Health Center | Case Management | 410 South Beltline, Suite 3, Scottsbluff, NE 69361 | 2007-05-16 |
| 1821201294 | Kay C. Gamet | Social Worker | 4410 Ave D, Scottsbluff, NE 69361 | 2007-05-08 |
| Find all providers in zip 69361 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104846070 | Christopher M. Lambert | Internal Medicine | Two W 52nd Street, Ste 2200, Scottsbluff, NE 69361-0617 | 2006-07-20 |
| 1003063959 | Moneera Nur Haque | Internal Medicine | 4021 Avenue B, Scottsbluff, NE 69361-4602 | 2008-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750903068 | Matrix Medical Network of Nebraska PC | Internal Medicine | 233 S 13th St Ste 1900, Lincoln, NE 68508-2000 | 2020-05-08 |
| 1467906487 | Arif Ishaq Albulushi | Internal Medicine | 9011 Burt St, Apt 106, Omaha, NE 68114-2477 | 2016-08-08 |
| 1578796207 | Krishna Naag Velagapudi | Internal Medicine | 110 N 29th St Ste 301, Norfolk, NE 68701-4466 | 2009-08-28 |
| 1639333883 | James N Karnegis | Internal Medicine | 20975 Bonanza Blvd, Elkhorn, NE 68022-1838 | 2008-07-16 |
| 1780725580 | Richard James Markiewicz | Internal Medicine | 601 W Leota St., North Platte, NE 69101 | 2007-02-12 |
| 1912055112 | Hemantha Kumar Koduri | Internal Medicine | 4445 S 86th St Ste 100, Lincoln, NE 68526 | 2007-01-06 |
| 1316025505 | Robert Lee Percell Jr. | Internal Medicine | 1600 S 48th St Ste 600, Lincoln, NE 68506-1275 | 2006-11-02 |
| 1861503427 | Antonio P Reyes | Internal Medicine | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2006-08-31 |
| 1184739989 | Dennis J Esterbrooks | Internal Medicine | 2412 Cuming St, Omaha, NE 68131-1601 | 2006-08-20 |
| 1083623706 | Panayotis-alain Efstratiou | Internal Medicine | 3219 Central Ave Ste 201, Kearney, NE 68847 | 2006-08-05 |
| Find all providers with the same taxonomy | ||||
| City | SCOTTSBLUFF |
| Zip Code | 69361 |
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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.