POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1356972301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356972301 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1208 Luther Street Eads CO 81036-0817 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7194385401 |
| Practice Fax Number | 7194385697 |
| Mailing Telephone | 7194385401 |
| Mailing Fax Number | 7194385697 |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |
| 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 | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Heart and Vascular Clinic - Eads | 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 |
1208 LUTHER STREET |
| City | EADS |
| State | CO |
| Zip Code | 81036-0817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366452732 | County of Kiowa Hospital District | General Acute Care Hospital | 1208 Luther Street, Eads, CO 81036 | 2006-08-09 |
| 1700413895 | Michael Briggs Archer Sr. | Nurse Practitioner | 1208 Luther Street, Eads, CO 81036 | 2020-03-26 |
| 1700115938 | County of Kiowa Hospital District | General Practice | 1208 Luther Street, Eads, CO 81036 | 2009-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326488982 | Prairie Pines | Assisted Living Facility | 101 E Lowell Ave, Eads, CO 81036 | 2013-06-27 |
| 1053436220 | Kiowa County Dept of Social Services | Bus | 1307 Maine St., Eads, CO 81036 | 2007-03-20 |
| 1538235841 | Kiowa Home Health Services | Home Health | 311 W 12th St, Eads, CO 81036 | 2006-11-28 |
| 1659464709 | County of Kiowa Hospital District | Clinic/Center | 1211 Luther St, Eads, CO 81036 | 2006-10-02 |
| 1013422310 | Jessica Rayleen Hyman | Nurse Practitioner | 1211 Luther Street, Eads, CO 81036 | 2017-12-08 |
| 1679917207 | County of Kiowa Hospital District | Nursing Facility/Intermediate Care Facility | 1208 Luther St, Eads, CO 81036 | 2013-04-25 |
| 1265695993 | Kiowa County Hospital District | Family Medicine | 1211 Luther Street, Eads, CO 81036 | 2008-07-02 |
| 1477639037 | Pharmacy Services Inc. | Pharmacy | 1201 Maine St., Eads, CO 81036-0010 | 2006-10-27 |
| 1386807550 | Renay Marie Crain | Registered Nurse | 1206 Luther St, Eads, CO 81036-0414 | 2008-07-08 |
| 1114180486 | Kiowa County Public Health Agency | Public Health or Welfare | 1206 Luther St, Eads, CO 81036-0414 | 2008-07-08 |
| Find all providers in zip 81036 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1013539113 | Poudre Valley Medical Group, LLC | Internal Medicine | 328 S Bonaventure Ave Ste 2, Trinidad, CO 81082-2086 | 2020-05-12 |
| Find all providers with the same taxonomy | ||||
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.