POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1932728540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932728540 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
16222 W Us Highway 24 Ste 210 Woodland Park CO 80863-8763 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7196862832 |
| Practice Fax Number | 7196862833 |
| Mailing Telephone | 7196862832 |
| Mailing Fax Number | 7196862833 |
| 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 |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Gastroenterology Clinic - Woodland Park | 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 |
16222 W US HIGHWAY 24 STE 210 |
| City | WOODLAND PARK |
| State | CO |
| Zip Code | 80863-8763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679815757 | Jason Aminsharifi | Surgery | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2013-03-26 |
| 1801402706 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-09-17 |
| 1215542519 | Poudre Valley Medical Group, LLC | Surgery | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-09-14 |
| 1114532801 | Poudre Valley Medical Group, LLC | Neurological Surgery | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-09-10 |
| 1669085882 | Poudre Valley Medical Group, LLC | Internal Medicine | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-08-27 |
| 1114546009 | Poudre Valley Medical Group, LLC | Otolaryngology | 16222 W Us Highway 24 Ste 210, Woodland Park, CO 80863-8763 | 2020-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576867 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 333 North West Street, Woodland Park, CO 80863 | 2020-07-23 |
| 1003461476 | Alive Connections Counseling, LLC | Community/Behavioral Health | 321 West Henrietta Avenue, Office D-8, Woodland Park, CO 80863 | 2019-08-02 |
| 1720630130 | Jennifer Fuller James | Social Worker | 400 W Midland Ave Ste 100h, Woodland Park, CO 80863 | 2019-07-15 |
| 1558861815 | Thrive Primary Care At Woodland Park LLC | Nurse Practitioner | 1067 Us 24, 276, Woodland Park, CO 80863 | 2018-02-13 |
| 1841712080 | Jamie Andersen | Marriage & Family Therapist | 321 W. Henrietta Ave, Suite B, Woodland Park, CO 80863 | 2017-07-10 |
| 1720438492 | Laurie Kim Warchol | Counselor | 321 West Henrietta, Woodland Park, CO 80863 | 2016-06-14 |
| 1255788402 | Colorado Lions Camp Inc | Respite Care | 28541 Highway 67, Wooodand Park, CO 80863 | 2016-05-18 |
| 1619337193 | Ariana Papi | Specialist/Technologist, Other | 16240 W Hwy 24, Woodland Park, CO 80863 | 2016-02-26 |
| 1104281864 | Daybreak-an Adult Day Program | Respite Care | 404 North Highway 67, Woodland Park, CO 80863 | 2015-12-23 |
| 1104281906 | Kingdom Pediatric Therapy | Speech-Language Pathologist | 1067 E Us Hwy, Pmb 72, Woodland Park, CO 80863 | 2015-12-21 |
| Find all providers in zip 80863 | ||||
| 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 |
|---|---|---|---|---|
| 1013351675 | Natasha Chhabra | Internal Medicine | 1031 Mcbride Avenue, Suite D212, Woodland Park, NJ 07424 | 2013-04-24 |
| 1558399030 | Michael Joseph Martino | Internal Medicine | 1031 Mcbride Ave Ste D212, Woodland Park, NJ 07424-2569 | 2006-06-30 |
| 1144259649 | Joseph George Shami | Internal Medicine | 205 Browertown Rd Ste 204, Woodland Park, NJ 07424-2610 | 2006-06-30 |
| 1023014909 | George Pavlou | Internal Medicine | 205 Browertown Rd Ste 201, Woodland Park, NJ 07424-2610 | 2005-06-24 |
| 1245505601 | Ori Avraham Rackovsky | Internal Medicine | 205 Browertown Road, Suite 202, Woodland Park, NJ 07424 | 2012-03-19 |
| 1306008446 | Ariy Volfson | Internal Medicine | 1031 Mcbride Ave Ste D212, Woodland Park, NJ 07424-2569 | 2008-06-30 |
| 1497932271 | Gastroenterology Associates of New Jersey, LLC | Internal Medicine | 1130 Mcbride Ave, Woodland Park, NJ 07424-3806 | 2008-01-24 |
| 1063618908 | Matthew Aaron Grossman | Internal Medicine | 205 Browertown Rd, Suite 204, Woodland Park, NJ 07424-2671 | 2007-06-26 |
| 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 |
| 1093313900 | Gi Care of Colorado Pllc | Internal Medicine | 3911 Ambrosia St Ste 201, Castle Rock, CO 80109-3888 | 2020-10-13 |
| 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 |
| 1720614803 | Healthone Clinic Services Medical Specialties LLC | Internal Medicine | 1808 Boise Ave Ste B, Loveland, CO 80538-5012 | 2020-03-20 |
| 1487210571 | Valley View Hospital Association | Internal Medicine | 1830 Blake Ave Ste 202, Glenwood Springs, CO 81601-4261 | 2019-05-14 |
| 1477907749 | Catholic Health Initiatives Colorado | Internal Medicine | 2030 Mountain View Ave Ste 310, Longmont, CO 80501-3181 | 2016-04-22 |
| 1225472327 | Nathan Schomaker | Internal Medicine | 10103 Ridgegate Pkwy Ste 312a, Lone Tree, CO 80124-5525 | 2013-04-19 |
| 1184967598 | Vihang Vijaykumar Patel | Internal Medicine | 2335 S Downing St Ste 360, Denver, CO 80210-5809 | 2013-04-03 |
| 1174867527 | Donald Lee Chilcoat | Internal Medicine | 7210 S Eudora Ct, Centennial, CO 80122-2400 | 2012-11-23 |
| Find all providers with the same taxonomy | ||||
| City | WOODLAND PARK |
| Zip Code | 80863 |
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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.