POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1932717063) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932717063 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1925 Mountain View Ave Longmont CO 80501-3128 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7204943132 |
| Practice Fax Number | 7204943107 |
| Mailing Telephone | 7204943132 |
| Mailing Fax Number | 7204943107 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| 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 | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Orthopedics Clinic - Longmont | 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 |
1925 MOUNTAIN VIEW AVE |
| City | LONGMONT |
| State | CO |
| Zip Code | 80501-3128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275538555 | Amy Lou Johnson | Obstetrics & Gynecology | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2005-06-14 |
| 1013522192 | Poudre Valley Medical Group, LLC | Urology | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-09-15 |
| 1164037248 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-09-15 |
| 1003421306 | Poudre Valley Medical Group, LLC | Urology | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-09-14 |
| 1922613603 | Poudre Valley Medical Group, LLC | Internal Medicine | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-09-10 |
| 1679186803 | Poudre Valley Medical Group, LLC | Internal Medicine | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-27 |
| 1942813167 | Poudre Valley Medical Group, LLC | Internal Medicine | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-27 |
| 1194338319 | Poudre Valley Medical Group, LLC | Radiology | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-27 |
| 1740893197 | Poudre Valley Medical Group, LLC | Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-26 |
| 1073126652 | Poudre Valley Medical Group, LLC | Pediatrics | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598376774 | Boulder County Public Health | Public Health or Welfare | 515 Coffman Street, Suite 200, Longmont, CO 80501 | 2020-08-12 |
| 1164032827 | Kidstuff Child and Family Counseling, P.C. | Marriage & Family Therapist | 360 15th Ave, Ste. 104, Longmont, CO 80501 | 2020-08-06 |
| 1861036501 | Stateserv Medical of Colorado | Durable Medical Equipment & Medical Supplies | 63 South Pratt Pkwy, Landmont, CO 80501 | 2019-11-06 |
| 1558915090 | Array Clinical and Therapeutic Services | Assistant Behavior Analyst | 451 21st Ave. Suite B, Longmont, CO 80501 | 2019-08-01 |
| 1275195042 | Alisa Marie Schwegerl | Speech-Language Pathologist | 1800 Stroh Place, Longmont, CO 80501 | 2019-07-02 |
| 1295298545 | Jovahna Pena | Counselor | Behavioral Health Group, 850 23rd Ave Unit A, Longmont, CO 80501 | 2019-04-12 |
| 1659845568 | University Physicians Incorporated | Advanced Practice Midwife | 2030 Mountain View Ave Ste 400, Longmont, CO 80501 | 2019-01-14 |
| 1013404714 | Crafted Physical Therapy Pllc | Physical Therapist | 701 Delaware Ave Unit E, Longmont, CO 80501 | 2018-04-18 |
| 1588110860 | Randall Bonnom | Counselor | 420 21st Ave #113, Longmont, CO 80501 | 2016-08-28 |
| 1225401771 | Sowash Optometry Group, PC | Eyewear Supplier (Equipment, not the service) | 1242 S. Hover Street, Suite C200, Longmont, CO 80501 | 2015-11-05 |
| Find all providers in zip 80501 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| 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 Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740411 | Gregg A. Koldenhoven | Orthopaedic Surgery | 1610 Dry Creek Dr Ste 200, Longmont, CO 80503-6405 | 2005-06-15 |
| 1942813613 | University Physicians Incorporated | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-24 |
| 1164089595 | John O Cletcher Jr. | Orthopaedic Surgery | 1610 Dry Creek Drive, Longmont, CO 80503 | 2019-05-21 |
| 1528487600 | Jared Shoji Pate | Orthopaedic Surgery | 1750 E Ken Pratt Blvd, Longmont, CO 80504-5311 | 2014-04-16 |
| 1558780452 | Christine Cleora Johnson | Orthopaedic Surgery | 1610 Dry Creek Dr, Longmont, CO 80503-6405 | 2014-04-08 |
| 1912218165 | Andrew Park | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2010-06-22 |
| 1376864942 | Daniel Kyeongtaek Moon | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2010-06-17 |
| 1528293271 | Sunil S Jani | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2009-05-26 |
| 1225203946 | Gavin Brett Bishop | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2008-04-23 |
| 1154339505 | James A Britton | Orthopaedic Surgery | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2006-08-03 |
| Find all providers in LONGMONT | ||||
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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.