POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1750910923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750910923 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
6767 29th St Fl 3 Greeley CO 80634-5474 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9706522740 |
| Practice Fax Number | 9706522733 |
| Mailing Telephone | 9706522740 |
| Mailing Fax Number | 9706522733 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| 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 | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Dermatology 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 3 |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-5474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649536723 | Eks Wye Pollock Iv | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2012-04-03 |
| 1144833146 | Poudre Valley Medical Group, LLC | Neurological Surgery | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-08-28 |
| 1255944831 | Poudre Valley Medical Group, LLC | Pediatrics | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-08-25 |
| 1598378176 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-08-25 |
| 1841814613 | Poudre Valley Medical Group, LLC | Preventive Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-06-08 |
| 1649892662 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-13 |
| 1588286678 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-12 |
| 1265054555 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-05-11 |
| 1235758012 | Poudre Valley Medical Group, LLC | Family Medicine | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-04-13 |
| 1336768480 | Poudre Valley Medical Group, LLC | Otolaryngology | 6767 29th St Fl 3, Greeley, CO 80634-5474 | 2020-04-09 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679988117 | Stephen P Castle D.o., P.C. | Dermatology | 7251 W 20th St Unit E, Greeley, CO 80634-4626 | 2014-06-24 |
| 1891913372 | Jennifer H Perryman | Dermatology | 8223 W 20th St, 100a, Greeley, CO 80634-3036 | 2007-04-23 |
| 1932217742 | Stephen Paul Castle | Dermatology | 7251 W 20th St, Bldg E, Greeley, CO 80634-4625 | 2006-08-29 |
| 1205813193 | Mary A Blattner | Dermatology | 5881 W 16th St, Greeley, CO 80634-2910 | 2005-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720685894 | Colorado Springs Dermatology Clinic, P.C. | Dermatology | 1332 Bauer Ln, Canon City, CO 81212-4669 | 2020-10-02 |
| 1891392973 | Colorado Springs Dermatology Clinic, P.C. | Dermatology | 2060 Briargate Pkwy Ste 150, Colorado Springs, CO 80920-7660 | 2020-10-02 |
| 1033723465 | Inspired Dermatology, Pllc | Dermatology | 6050 Greenwood Plaza Blvd Ste 130, Greenwood Village, CO 80111-4823 | 2020-09-02 |
| 1700496668 | Sorkin Dermatology Associates Professional LLC | Dermatology | 1960 N. Ogden Street, Suite 555, Denver, CO 80218-3602 | 2020-08-05 |
| 1194340802 | Epiphany Dermatology of Colorado, LLC | Dermatology | 2530 N 8th St Ste 205, Grand Junction, CO 81501-8858 | 2020-06-09 |
| 1861026189 | University Physicians Incorporated | Dermatology | 14305 E Alameda Ave Ste 225, Aurora, CO 80012-2549 | 2020-02-25 |
| 1316577323 | Medical Man Cave Pllc | Dermatology | 250 Steele Street, Suite 350, Denver, CO 80206-5242 | 2020-01-17 |
| 1124664248 | Allison Marquis | Dermatology | 4350 Limelight Ave Ste 205, Castle Rock, CO 80109-8034 | 2019-11-24 |
| 1790255313 | Core Dermatology, Pllc | Dermatology | 425 South Cherry Suite 907, Glendale, CO 80246 | 2018-11-26 |
| 1326521576 | Kaitlyn Laurel Pell | Dermatology | 125 Inverness Dr E Ste 340, Englewood, CO 80112-5139 | 2018-09-13 |
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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.