POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1083227243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083227243 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1750 E Ken Pratt Blvd Fl 3 Longmont CO 80504-5311 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7207183900 |
| Practice Fax Number | 7207180999 |
| Mailing Telephone | 7207183900 |
| Mailing Fax Number | 7207180999 |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |
| 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 | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Pediatric Care - Longs Peak Hospital | 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 |
1750 E KEN PRATT BLVD FL 3 |
| City | LONGMONT |
| State | CO |
| Zip Code | 80504-5311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124245543 | Sarah J Mckinley | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504 | 2007-04-19 |
| 1891300596 | Poudre Valley Medical Group, LLC | Surgery | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-09-10 |
| 1588277701 | Poudre Valley Medical Group, LLC | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-08-27 |
| 1427678267 | Poudre Valley Medical Group, LLC | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-04-22 |
| 1619382496 | Kyle Jacob Thompson | Surgery | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2014-06-30 |
| 1952627473 | Maria Mildred Herrera | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2010-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942776620 | Cinde S Yoho | Social Worker | 9485 County Road 15, Firestone, CO 80504 | 2018-10-19 |
| 1427544881 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 310 Lashley St Ste 109, Longmont, CO 80504 | 2018-07-09 |
| 1962913962 | Melissa Frick | Counselor | 10184 E I-25 Frontage Rd, Firestone, CO 80504 | 2017-10-17 |
| 1558757260 | Firestone Pediatric Dentistry and Orthodontics | Dentist | 8301 Colorado Blvd, Suite 200, Firestone, CO 80504 | 2015-04-09 |
| 1912392671 | Ashley Lerwick | Speech-Language Pathologist | 11169 Interstate I25 Frontage Rd, Firestone, CO 80504 | 2015-03-31 |
| 1780077685 | Roger Leon Jorgensen | Ophthalmology | 14222 N 95 Si, Longmont, CO 80504 | 2015-03-17 |
| 1982942090 | Carrie Rose Fitzekam | Technician | 712 Tanagers Circle, Longmont, CO 80504 | 2013-01-24 |
| 1003166976 | Jennifer Lynn Mcnerney | Speech-Language Pathologist | 8197 Miller Dr, Frederick, CO 80504 | 2012-09-18 |
| 1821343450 | Allison Luellen | Physician Assistant | 8350 Colorado Blvd, Suite 160, Firestone, CO 80504 | 2012-07-19 |
| 1609132109 | Abby Elizabeth Bohall | Speech-Language Pathologist | 5132 Mt Buchanan Ave, Frederick, CO 80504 | 2012-04-09 |
| Find all providers in zip 80504 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126652 | Poudre Valley Medical Group, LLC | Pediatrics | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-25 |
| 1285258657 | Obstetrix Medical Group of Colorado, P.C. | Pediatrics | 1950 Mountain View Ave, Longmont, CO 80501-3129 | 2020-06-02 |
| 1780047902 | Catholic Health Initiatives Colorado | Pediatrics | 2101 Ken Pratt Blvd Ste 200, Longmont, CO 80501-6568 | 2016-04-04 |
| 1497174940 | Jesse Aaron Mortimore | Pediatrics | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2014-04-14 |
| 1144663998 | Kimberly Slonaker | Pediatrics | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2013-04-11 |
| 1063600096 | Katherine Dueber | Pediatrics | 1925 W Mountain View Ave, Longmont, CO 80501-3128 | 2007-10-03 |
| 1720118664 | Kraig A Schmidt | Pediatrics | 2345 Bent Way, Longmont, CO 80503-7614 | 2007-03-07 |
| 1023152824 | Michael R Martinez | Pediatrics | 2345 Bent Way, Longmont, CO 80503-7614 | 2007-02-16 |
| 1417018649 | Colette Elise Fisher | Pediatrics | 2345 Bent Way, Longmont, CO 80503-7614 | 2006-12-12 |
| 1699772392 | Lisa A Turner | Pediatrics | 1925 W Mountain View Ave, Longmont, CO 80501-3128 | 2005-07-07 |
| 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.