POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1104440973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104440973 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4323 Integrity Center Pt Colorado Springs CO 80917-1683 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7195912558 |
| Practice Fax Number | 7195912596 |
| Mailing Telephone | 7195912558 |
| Mailing Fax Number | 7195912596 |
| Enumeration Date | 2020-06-08 |
| Last Update Date | 2020-06-08 |
| 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 | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Occupational Medicine Clinic - Powers | 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 |
4323 INTEGRITY CENTER PT |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80917-1683 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356328454 | Lori L Japp | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2005-12-29 |
| 1447724505 | Poudre Valley Medical Group, LLC | Clinic/Center | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2019-01-11 |
| 1437657640 | Krystal Rockhold | Nurse Practitioner | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2018-01-23 |
| 1407363633 | Jayme Eatough | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917 | 2018-01-09 |
| 1588929913 | Crystal Michealson | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2012-07-11 |
| 1346514163 | Emily Kristen Burns | Preventive Medicine | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2012-02-24 |
| 1023259025 | Integrity Urgent Care | Non-Pharmacy Dispensing Site | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2009-03-20 |
| 1912189788 | Integrity Urgent Care, P.C. | Clinic/Center | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2007-12-03 |
| 1902025935 | Edwin L Baca | Family Medicine | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2007-04-25 |
| 1588703904 | Jean-luc Francois Houlne | Physician Assistant | 4323 Integrity Center Pt, Colorado Springs, CO 80917-1683 | 2007-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952910499 | Select Physical Therapy of Colorado Springs Lp | Durable Medical Equipment & Medical Supplies | 5660 Barnes Road, Suite 116, Colorado Springs, CO 80917 | 2020-07-30 |
| 1043796774 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3475 North Academy Blvd, Colorado Springs, CO 80917 | 2018-07-16 |
| 1598273153 | Ariana Goemaere | Behavior Technician | 3535 Parkmoor Village Dr, Colorado Springs, CO 80917 | 2018-01-17 |
| 1366959769 | Behavioral Health Consultants, Inc. | Clinic/Center | 3210 North Academy Blvd, Suite 3, Colorado Springs, CO 80917 | 2018-01-08 |
| 1558870030 | Falisha Rief | Assistant Behavior Analyst | 2790 North Academy Blvd, Suite 180, Colorado Springs, CO 80917 | 2017-09-27 |
| 1407374655 | Christina Otto | Assistant Behavior Analyst | 2790 North Academy, Suite 180, Colorado Springs, CO 80917 | 2017-09-07 |
| 1992155956 | Georgina Segura | Nurse Practitioner | 5135 Iron Horse Trl, Colorado Springs, CO 80917 | 2016-06-20 |
| 1952685182 | Barbara Hazard Henning | Pharmacist | 3840 N Academy Blvd, Colorado Springs, CO 80917 | 2011-10-06 |
| 1659651412 | Nicole Blakesley | Psychologist | 3264 Vail Pass Drive, Colorado Springs, CO 80917 | 2011-08-25 |
| 1427360254 | Austinbluffs Dental Prof. LLC | Dentist | 3952 North Academy, Colorado Springs, CO 80917 | 2010-07-09 |
| Find all providers in zip 80917 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275171977 | Poudre Valley Medical Group, LLC | Preventive Medicine | 2773 Janitell Rd, Colorado Springs, CO 80906-4102 | 2019-12-13 |
| 1558569384 | Kyle Clayton Akers | Preventive Medicine | 701 N Circle Dr, Colorado Springs Utilities Safety & Health Dept., Colorado Springs, CO 80909-5121 | 2007-07-03 |
| 1336264480 | Craig H. Durck | Preventive Medicine | 5320 Mark Dabling Blvd, Building 7 - Suite 100, Colorado Springs, CO 80918-3839 | 2007-03-20 |
| 1164573739 | Bradley Gerard Beck | Preventive Medicine | 12340 Herring Rd, Colorado Springs, CO 80908-4194 | 2007-01-12 |
| 1013531888 | Poudre Valley Medical Group, LLC | Preventive Medicine | 13445 Voyager Pkwy, Colorado Springs, CO 80921-7648 | 2020-06-08 |
| 1932723707 | Poudre Valley Medical Group, LLC | Preventive Medicine | 1035 Garden of The Gods Rd Ste 120, Colorado Springs, CO 80907-3416 | 2020-06-08 |
| 1164744587 | Mary M. Dickson | Preventive Medicine | 6011 E Woodmen Rd, Suite 100, Colorado Springs, CO 80923-2602 | 2010-02-26 |
| 1992827869 | Daniel M Peterson | Preventive Medicine | 5320 Mark Dabling Blvd, Suite 100, Colorado Springs, CO 80918-3839 | 2007-04-04 |
| 1760406359 | Jag Mohan S Walia | Preventive Medicine | 320 E Fontanero St, Colorado Springs, CO 80907-7529 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894963 | Scl Health Medical Group - Denver, LLC | Preventive Medicine | 8515 W Coal Mine Ave Ste 240, Littleton, CO 80123-4429 | 2020-09-04 |
| 1568070944 | Scl Health Medical Group - Denver, LLC | Preventive Medicine | 8350 Colorado Blvd Unit 160, Firestone, CO 80504-6803 | 2020-07-21 |
| 1548776784 | Telecare Global LLC | Preventive Medicine | 11 Salvation Circle, Aspen, CO 81611 | 2017-12-26 |
| 1306363650 | Bonnie Belinda Mccafferty | Preventive Medicine | Denver Federal Center, Federal Occupational Health, Building 25, Entrance E-14, Lakewood, CO 80225-0145 | 2017-08-28 |
| 1447784087 | Colorado Occupational Partners, Inc. | Preventive Medicine | 1390 S Potomac St Ste 136, Aurora, CO 80012-4529 | 2017-04-19 |
| 1992040786 | Homefront Health and Occupational Medicine LLC | Preventive Medicine | 1705 32nd St., Evans, CO 80620 | 2012-12-05 |
| 1144598855 | Daniel Thau Teitelbaum | Preventive Medicine | 355 Ogden St, Denver, CO 80218-3867 | 2011-12-08 |
| 1952604985 | Michael Verne Ladwig | Preventive Medicine | 6900 E 47th Avenue Dr Ste 100, Denver, CO 80216-3449 | 2010-12-14 |
| 1831374776 | Lisa Beth Ferstenberg | Preventive Medicine | 302 W Orman Ave, Pueblo, CO 81004-1855 | 2008-01-09 |
| 1275714883 | James Allen Hebard | Preventive Medicine | 290 Nickel Street, Suite 200, Broomfield, CO 80020 | 2007-11-26 |
| Find all providers with the same taxonomy | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80917 |
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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.