POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1427678267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427678267 |
| 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 | 7204943117 |
| Practice Fax Number | 3034853348 |
| Mailing Telephone | 7204943117 |
| Mailing Fax Number | 3034853348 |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |
| 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 - 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 |
| 1083227243 | Poudre Valley Medical Group, LLC | Pediatrics | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-08-27 |
| 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 | 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 |
|---|---|---|---|---|
| 1427060383 | Daniel S White | Internal Medicine | 2101 Ken Pratt Blvd Ste 104, Longmont, CO 80501-6568 | 2006-08-12 |
| 1336769173 | Poudre Valley Medical Group, LLC | Internal Medicine | 2030 Mountain View Ave Ste 540, Longmont, CO 80501-3183 | 2020-04-22 |
| 1619597739 | Poudre Valley Medical Group, LLC | Internal Medicine | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-04-18 |
| 1992798243 | Imran Zubair | Internal Medicine | 2030 Mountain View Ave, Ste 300, Longmont, CO 80501-3178 | 2005-08-23 |
| 1417957416 | John Abboud | Internal Medicine | 2030 Mountain View Ave, Ste 300, Longmont, CO 80501-3178 | 2005-08-01 |
| 1902803174 | John Stathis | Internal Medicine | 1925 W Mountain View Ave, Longmont, CO 80501-3128 | 2005-07-03 |
| 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 | ||||
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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.