POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1912526526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912526526 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
525 Bob Peters Grv Ste 202 Colorado Springs CO 80909-4533 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7196361201 |
| Practice Fax Number | 7196361326 |
| Mailing Telephone | 7196361201 |
| Mailing Fax Number | 7193631326 |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |
| 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 |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth GI Cancer Multidisciplinary Clinic - Memorial Hospital Centra | 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 |
525 BOB PETERS GRV STE 202 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80909-4533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952414872 | Rebecca Erin Crank | Physician Assistant | 525 Bob Peters Grv Ste 202, Colorado Springs, CO 80909-4533 | 2006-08-16 |
| 1669001822 | Poudre Valley Medical Group, LLC | Internal Medicine | 525 Bob Peters Grv Ste 202, Colorado Springs, CO 80909-4533 | 2020-04-08 |
| 1659635159 | Rubens Chang | Internal Medicine | 525 Bob Peters Grv Ste 202, Colorado Springs, CO 80909-4533 | 2012-06-28 |
| 1447539887 | Naga Venkata Kalipraveena Iruku | Internal Medicine | 525 Bob Peters Grv Ste 202, Colorado Springs, CO 80909-4533 | 2011-08-16 |
| 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 | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1700484359 | Gi Care of Colorado Pllc | Internal Medicine | 6031 East Woodmen Rd, Suite 100, Colorado Springs, CO 80923-2606 | 2020-10-15 |
| 1902433865 | Healthone Clinic Services Medical Specialties LLC | Internal Medicine | 6965 Tutt Blvd Ste 210, Colorado Springs, CO 80923-3598 | 2020-03-23 |
| 1245866326 | Healthone Clinic Services Medical Specialties LLC | Internal Medicine | 6965 Tutt Blvd, Colorado Springs, CO 80923-3596 | 2020-03-20 |
| 1851534267 | Poorna Ramachandran | Internal Medicine | 2920 N Cascade Ave Ste 300, Colorado Springs, CO 80907-6262 | 2009-04-15 |
| 1144369984 | William Jeff Wooddell | Internal Medicine | 825 East Pikes Peak Ave, Suite 600 Pikes Peak Hospice, Colorado Springs, CO 80903-3624 | 2007-02-06 |
| 1427107770 | Caroline R. Tadros | Internal Medicine | 1699 Medical Center Point, Colorado Springs, CO 80907 | 2007-01-09 |
| 1730271503 | Sue M Mitchell | Internal Medicine | 1699 Medical Center Pt, Colorado Springs, CO 80907-5700 | 2006-09-29 |
| 1710967260 | Austin Edward Garza | Internal Medicine | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 | 2006-01-19 |
| 1740888676 | Gi Care of Colorado Pllc | Internal Medicine | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 | 2020-10-13 |
| 1679830871 | Diana Arsene | Internal Medicine | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 | 2012-04-12 |
| 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.