POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1710593611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710593611 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1024 S Lemay Ave Fort Collins CO 80524-3929 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9704958440 |
| Practice Fax Number | 9704957644 |
| Mailing Telephone | 9704958440 |
| Mailing Fax Number | 9704957644 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| 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 | 163WW0000X |
Registered Nurse Specialization: Wound Care |
Nursing Service Providers |
| Other Name | Type Code |
|---|---|
| UCHealth Wound Care Clinic - Fort Collins | 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 |
1024 S LEMAY AVE |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80524-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659181 | Dennis P. Brant | Emergency Medicine | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2005-06-17 |
| 1164021911 | Poudre Valley Medical Group, LLC | Social Worker | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-10-22 |
| 1902419120 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-08-27 |
| 1467065680 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-08-27 |
| 1356953939 | Denise Patten | Pharmacist | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-08-17 |
| 1609484302 | Poudre Valley Medical Group, LLC | Internal Medicine | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-07-20 |
| 1396369492 | Whitney Raye Pollard | Counselor | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-06-04 |
| 1922620897 | Poudre Valley Medical Group, LLC | General Practice | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-05-13 |
| 1134740913 | Haley R Rider | Speech-Language Pathologist | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-05-03 |
| 1831722099 | Kelly Smith | Social Worker | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084612 | Summitstone Health Partners | Clinic/Center | 1008 Patton St., Fort Collins, CO 80524 | 2020-08-20 |
| 1396355244 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 1006 Robertson St., Ste. 120, Fort Collins, CO 80524 | 2020-08-05 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1013496835 | Stepheny Nicol Chapple | Psychologist | 701 S College Drive, 201, Fort Collins, CO 80524 | 2018-08-13 |
| 1609372432 | Tracy Jo Close | Counselor | 1031 Robinson Street, Fort Collins, CO 80524 | 2018-04-02 |
| 1831617828 | Rachel Elizabeth Brenner | Counselor | 151 W Lake Rd, Csu Health Network Counseling Services, Fort Collins, CO 80524 | 2017-08-30 |
| 1205366820 | Victoria Marie Sechser | Specialist/Technologist | 1102 Peterson St, Fort Collins, MN 80524 | 2017-06-15 |
| 1013367705 | Smith Street LLC | Day Training, Developmentally Disabled Services | 308 Smith St., Fort Collins, CO 80524 | 2016-06-14 |
| 1811344989 | Ignite Speech-language Services | Clinic/Center | 3921 Celtic Lane, Fort Collins, CO 80524 | 2016-05-18 |
| Find all providers in zip 80524 | ||||
| Taxonomy Code | 163WW0000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Wound Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715547 | Maura Ann Doran Snyder | Registered Nurse | 2912 Lake Hollow Rd, Berthoud, CO 80513-8461 | 2020-09-18 |
| 1447866082 | Melissa Moore | Registered Nurse | 2912 Lake Hollow Rd, Berthoud, CO 80513-8461 | 2020-09-18 |
| 1447632153 | Debbie Barnes | Registered Nurse | 1719 E 19th Ave, 5b, Denver, CO 80218-1235 | 2015-06-18 |
| 1487996625 | Melissa Shannon Dubois | Registered Nurse | 300 Exempla Cir Ste 360, Lafayette, CO 80026-3395 | 2013-03-26 |
| 1740534809 | Deborah Bernice Smith | Registered Nurse | 10065 E Harvard Ave Ste 400, Denver, CO 80231-5943 | 2012-10-28 |
| 1538462056 | Wound Care Associates Inc | Registered Nurse | 945 Logan Ct, Loveland, CO 80538-3100 | 2010-12-06 |
| City | FORT COLLINS |
| Zip Code | 80524 |
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.