POUDRE VALLEY MEDICAL GROUP, LLC


Address: 328 S Bonaventure Ave Ste 2, Trinidad, CO 81082-2086
Phone: 7198453183

POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1013539113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013539113
Entity Type Organization
Organization Name POUDRE VALLEY MEDICAL GROUP, LLC
Practice Address 328 S Bonaventure Ave Ste 2
Trinidad
CO 81082-2086
Mailing Address 2695 Rocky Mountain Ave Ste 150
Loveland
CO 80538-9071
Practice Telephone 7198453183
Practice Fax Number 7198467312
Mailing Telephone 7198453183
Mailing Fax Number 7198467312
Enumeration Date 2020-05-12
Last Update Date 2020-05-12
Authorized Official Name JANA CONROY (CREDENTIALING MANAGER)
Authorized Official Telephone 9706244443
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
UCHealth Heart Clinic - Trinidad Other Name - Individual/Organization

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Poudre Valley Medical Group, LLC 2695 Rocky Mountain Ave., Suite 110, Loveland, CO 80538

Office Location

Street Address 328 S BONAVENTURE AVE STE 2
City TRINIDAD
State CO
Zip Code 81082-2086

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710509583 Crossroads' Turning Points, Inc. Substance Abuse Rehabilitation Facility 1004 Carbon Place, Trinidad, CO 81082 2020-05-14
1912427030 Gwyndolyn Suzanne Snyder Nurse Practitioner 1112 Grant Ave, Trinidad, CO 81082 2017-06-20
1336273143 Online Therapy Services Inc. Speech-Language Pathologist 207 E Main, Trinidad, CO 81082 2007-03-15
1023119203 Paul Andreatta D.d.s.p.c. Dentist 1723 E. Main St., Trinidad, CO 81082 2006-09-26
1467400309 Trinidad Area Health Association Internal Medicine 400 Benedicta Ave Ste A, Trinidad, CO 81082 2006-05-04
1235651670 Kevin Patrick Crosby Counselor 417 S Indiana Ave, Trinidad, CO 81082 2017-07-07
1174054928 Brittany Ladonna Jauernig Chiropractor 500 San Juan St, Trinidad, CO 81082 2017-03-23
1982142188 Southern Colorado Developmental Disabilities Services, Inc Case Manager/Care Coordinator 415 S Indiana Ave, Trinidad, CO 81082 2017-02-08
1295001071 James Ashley Ward Counselor 417 S Indiana Ave, Trinidad, CO 81082 2012-03-27
1275704694 Steven David Blohm Dentist 209 E Main, Trinidad, CO 81082 2008-03-13
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821604257 Healthone Heart Care LLC Internal Medicine 310 County Rd, Suite 14, Del Norte, CO 81132 2020-09-21
1659987063 Healthone Heart Care LLC Internal Medicine 1444 S Potomac St Ste 310, Aurora, CO 80012-4508 2020-09-21
1225644834 Healthone Heart Care LLC Internal Medicine 1421 S Potomac St Ste 315, Aurora, CO 80012-4512 2020-09-18
1750995247 Scl Health Medical Group - Denver, LLC Internal Medicine 32135 Castle Ct Ste 100a, Evergreen, CO 80439-8005 2020-09-02
1518570977 Scl Health Medical Group - Denver, LLC Internal Medicine 1960 N Ogden St Ste 540a, Denver, CO 80218-3666 2020-08-26
1982213328 Catholic Health Initiatives Colorado Internal Medicine 1000 Granby Park Dr, Granby, CO 80446-0000 2020-07-30
1437768009 Catholic Health Initiatives Colorado Internal Medicine 920 Rush Dr Ste A, Salida, CO 81201-9669 2020-07-29
1437768124 Scl Health Medical Group - Denver, LLC Internal Medicine 3655 Lutheran Pkwy Ste 201, Wheat Ridge, CO 80033-6010 2020-07-28
1952927527 Platte Valley Medical Group, LLC Internal Medicine 1610 Prairie Center Pkwy Ste 2330, Brighton, CO 80601-4003 2020-06-19
1225658057 Poudre Valley Medical Group, LLC Internal Medicine 2315 San Juan Avenue, La Junta, CO 81050 2020-04-22
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Competitor

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City TRINIDAD
Zip Code 81082

Improve Information

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Dataset Information

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.

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