POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1811519101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811519101 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1400 E Boulder St Ste 500 Colorado Springs CO 80909-5533 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193644120 |
| Mailing Telephone | 7193644120 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| 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 | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Ear, Nose and Throat Clinic - Memorial Hospital Central | 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 |
1400 E BOULDER ST STE 500 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80909-5533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972683084 | Gary Markham Enger | Physician Assistant | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2006-10-16 |
| 1134726003 | Hannah Paik | Registered Nurse | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2020-10-05 |
| 1710460092 | Christine Christiansen | Registered Nurse | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2018-09-12 |
| 1295258887 | Elena Adams | Physician Assistant | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2017-07-25 |
| 1336686609 | Robert John Ferguson | Nurse Practitioner | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2017-01-25 |
| 1366809402 | Julie Cortez | Physician Assistant | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2016-01-20 |
| 1811284417 | Ashley Katherine Mccusker | Surgery | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2011-07-01 |
| 1649481805 | Patricia Suzanne Harner | Nurse Practitioner | 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 | 2007-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376173765 | Ascent Health LLC | Community/Behavioral Health | 2608 Palmer Park Blvd., Colorado Springs, CO- COLORADO 80909 | 2020-01-24 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| 1437706231 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 445 N Circle Drive, Colorado Springs, CO 80909 | 2019-08-26 |
| 1760952964 | James Garofalo | Counselor | 2210 E La Salle St Ste 221, Colorado Spgs, CO 80909 | 2018-11-29 |
| 1144719055 | Autumn Leaves Counseling, LLC | Counselor | 2130 Academy Circle, Suite B, Co Springs, CO 80909 | 2018-05-07 |
| 1407353642 | Ambulnz Co, LLC | Ambulance | 2420 E Pikes Peak Ave Ste 1001, Colorado Springs, CO 80909 | 2018-04-12 |
| 1083117998 | Peak Wellness Counseling Service, LLC | Counselor | 2210 E. La Salle Street, Suite 208, Colorado Springs, CO 80909 | 2018-03-16 |
| 1043740822 | Ande Carol West | Dental Hygienist | 701 Citadel Drive East, Colorado Springs, CO 80909 | 2017-06-14 |
| 1043748791 | Colorado Springs Pharmacy LLC | Pharmacy | 2224 E. Pikes Peak Ave, Colorado Springs, CO 80909 | 2017-05-25 |
| 1215484365 | Brittney Nicole Roberts | Physical Therapist | 2201 Lelaray St., Colorado Springs, CO 80909 | 2016-09-07 |
| Find all providers in zip 80909 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467829309 | Pikes Peak Ent | Otolaryngology | 9475 Briar Village Pt Ste 225, Colorado Springs, CO 80920 | 2015-08-26 |
| 1417343153 | Ralph Talbot Kendall | Otolaryngology | 3502 Pine Tree Sq, Colorado Springs, CO 80909-6436 | 2015-04-09 |
| 1134513351 | Planet T Hormone Replacement Center | Otolaryngology | 2631 W Colorado Ave, Colorado Springs, CO 80904-3024 | 2015-03-25 |
| 1043295355 | Ear Nose and Throat of Colorado Springs PC | Otolaryngology | 2403 N Union Blvd, Suite 103, Colorado Springs, CO 80909-1185 | 2005-12-09 |
| 1235128588 | David Thomas Book | Otolaryngology | 595 Chapel Hills Dr Ste 240, Colorado Springs, CO 80920 | 2005-10-19 |
| 1073506929 | William Kelly Mccarty | Otolaryngology | 2105 Academy Cir, Suite 100, Colorado Springs, CO 80909-1658 | 2005-08-25 |
| 1356960405 | Poudre Valley Medical Group, LLC | Otolaryngology | 595 Chapel Hills Dr Ste 240, Colorado Springs, CO 80920-1056 | 2020-04-09 |
| 1891114260 | Nicholas Alan Beckmann | Otolaryngology | 3030 N Circle Dr Ste 300, Colorado Springs, CO 80909-1180 | 2014-04-14 |
| 1154760866 | Robert G Keller | Otolaryngology | 3030 N Circle Dr Ste 300, Colorado Springs, CO 80909 | 2013-06-17 |
| 1477796332 | Matthew John Whinery | Otolaryngology | 3030 N Circle Dr, Ste 300, Colorado Springs, CO 80909-1177 | 2009-04-08 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80909 |
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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.