POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1306163621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306163621 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Other Organization Name | UCHEALTH HEART AND VASCULAR CLINIC - HARMONY CAMPUS |
| Practice Address |
2121 E Harmony Rd Unit 100 Fort Collins CO 80528-3401 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9702211000 |
| Practice Fax Number | 9702976844 |
| Mailing Telephone | 9702211000 |
| Mailing Fax Number | 9702976844 |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2019-12-23 |
| Authorized Official Name | JANA CONROY (MANAAGER CREDENTIALING) |
| Authorized Official Telephone | 9706244443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PVMG, Heart Center of the Rockies | Other Name - Individual/Organization |
| UCHealth Heart and Vascular Clinic - Harmony Campus | Doing Business As Name - 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 |
2121 E HARMONY RD UNIT 100 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80528-3401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487762167 | Mohamed Zaki Ahmed Refaat | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2006-08-25 |
| 1275015547 | Amy S Dickinson | Registered Nurse | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2018-09-04 |
| 1326597683 | Maria Kelley | Registered Nurse | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2016-09-28 |
| 1245676493 | Jordan Andrew Hess | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2013-05-15 |
| 1689917437 | Michael Adam Weinreich | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2013-03-30 |
| 1447519905 | Robert Rayson | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2012-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518475391 | Corinna Kromer | Specialist | 4818 Snowdrift Circle, Fort Collins, CO 80528 | 2018-01-16 |
| 1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
| 1790231413 | Pineridge Healthcare, Inc. | Skilled Nursing Facility | 4880 Ziegler Road, Fort Collins, CO 80528 | 2016-09-01 |
| 1750647244 | Annika Svea Kamberelis | Physician Assistant | 2121 E Harmony Rd Unit 300, Fort Collins, CO 80528 | 2012-04-09 |
| 1831481944 | Natasha E. Walter-fisk | Counselor | 5225 White Willow Dr. M220, Fort Collins, CO 80528 | 2011-05-07 |
| 1629216627 | Augusto Miravalle | Psychiatry & Neurology | 2121 E. Harmony Road, Suite 180, Ft Collins, CO 80528 | 2009-01-29 |
| 1114100252 | Alicia R. Young | Psychologist | 8010 S Country Road 5, Suite 201, Windsor, CO 80528 | 2007-12-12 |
| 1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
| 1437368578 | Shelley M Oliver | Orthopaedic Surgery | 2121 E. Harmony Rd. Ste 290, Fort Collins, CO 80528 | 2007-05-22 |
| 1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
| Find all providers in zip 80528 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487762167 | Mohamed Zaki Ahmed Refaat | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2006-08-25 |
| 1649871880 | Poudre Valley Medical Group, LLC | Internal Medicine | 1107 S Lemay Ave, Fort Collins, CO 80524-3960 | 2020-11-04 |
| 1689917437 | Michael Adam Weinreich | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2013-03-30 |
| 1457517625 | Wendy J Austin | Internal Medicine | 2121 E Harmony Rd, Suite 100, Fort Collins, CO 80528-3400 | 2008-08-06 |
| 1609931005 | Matthew T Purvis | Internal Medicine | 2121 E Harmony Rd, Ste 100, Fort Collins, CO 80528-3400 | 2006-12-26 |
| 1245236371 | Thomas R Downes IIi | Internal Medicine | 2121 E Harmony Rd, Ste100, Fort Collins, CO 80528-3400 | 2005-06-23 |
| 1053317198 | Charles Timothy Johnson | Internal Medicine | 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | 2005-06-23 |
| 1891791950 | Dennis G Larson | Internal Medicine | 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | 2005-06-23 |
| 1457357824 | Todd B Whitsitt | Internal Medicine | 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | 2005-06-22 |
| 1336145747 | Chad L Stoltz | Internal Medicine | 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | 2005-06-22 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80528 |
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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.