POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1952916587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952916587 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
6767 29th St Fl 2 Greeley CO 80634-5474 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9706522426 |
| Practice Fax Number | 9706522478 |
| Mailing Telephone | 9706522426 |
| Mailing Fax Number | 9706522478 |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2020-09-10 |
| 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 | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Surgical Clinic - Greeley Midtown | 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 2 |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-5474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932180551 | Daniel Henry Monkowski | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2005-11-10 |
| 1679188759 | Poudre Valley Medical Group, LLC | Urology | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-09-15 |
| 1770196990 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-08-27 |
| 1154934388 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-08-27 |
| 1023626157 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-07-15 |
| 1053933168 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-05-12 |
| 1285256388 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-05-12 |
| 1376162206 | Poudre Valley Medical Group, LLC | Internal Medicine | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2020-04-10 |
| 1598296949 | Rachel Slick | Social Worker | 6767 29th St Fl 2, Greeley, CO 80634-5474 | 2017-03-27 |
| 1699180364 | Caren Millard | Surgery | 6767 29th St Fl 2, Greeley, CO 80634 | 2014-06-21 |
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942438023 | Khoi Dinh Le | Surgery | 1800 15th St., Suite 200, Greeley, CO 80631 | 2009-06-26 |
| 1881781292 | North Colorado Surgery Center LLC | Surgery | 2000 70th Avenue, Greeley, CO 80634 | 2006-10-06 |
| 1851382634 | Lawrence Gustavo Davis | Surgery | 6767 West 29th Street, Greeley, CO 80634 | 2005-11-02 |
| 1699180364 | Caren Millard | Surgery | 6767 29th St Fl 2, Greeley, CO 80634 | 2014-06-21 |
| 1194972091 | Molly E Decker | Surgery | 1801 16th St, Greeley, CO 80631-5154 | 2008-08-21 |
| 1306001797 | Kelsey Rains Shay | Surgery | 1801 16th Street, Greeley, CO 80631 | 2008-07-24 |
| 1609049287 | Samuel Lee Saltz | Surgery | 1800 15th St, Suite 210, Greeley, CO 80631-4500 | 2008-04-03 |
| 1407878598 | John Michael Fessenden | Surgery | 1900 16th St, Greeley, CO 80631-5114 | 2006-07-24 |
| 1790700029 | Michael W Johnell | Surgery | 1801 16th St, Greeley, CO 80631-5154 | 2006-07-13 |
| 1275574758 | Jason W Ogren | Surgery | 1900 16th St, Greeley, CO 80631-5114 | 2006-06-08 |
| Find all providers in GREELEY | ||||
Please comment or provide details below to improve the information on POUDRE VALLEY MEDICAL GROUP, LLC.
| 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.