POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1437762028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1437762028 |
Entity Type | Organization |
Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
Practice Address |
1625 Medical Center Pt Ste 220 Colorado Springs CO 80907-5798 |
Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
Practice Telephone | 7195781112 |
Practice Fax Number | 7195780128 |
Mailing Telephone | 7195781112 |
Mailing Fax Number | 7195780128 |
Enumeration Date | 2020-08-25 |
Last Update Date | 2020-08-25 |
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 | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
UCHealth Plastic and Reconstructive Surgery Clinic - Colorado Springs | 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 |
1625 MEDICAL CENTER PT STE 220 |
City | COLORADO SPRINGS |
State | CO |
Zip Code | 80907-5798 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619138310 | Nancy Wong | Plastic Surgery | 1625 Medical Center Pt Ste 220, Colorado Springs, CO 80907 | 2008-06-24 |
1124514252 | Paige Schwab | Physician Assistant | 1625 Medical Center Pt Ste 220, Colorado Springs, CO 80907-5798 | 2018-07-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871124057 | Margaret Elizabeth Macnabb | Occupational Therapist | 955 West Fillmore Street, Colorado Springs, CO 80907 | 2020-01-28 |
1598300394 | Eric L Peterson | Counselor | 4570 Hilton Pwky, Colorado Springs, CO 80907 | 2019-11-15 |
1669020160 | Vcphcs Xii, LLC | Clinic/Center | 4157-4159 Centennial Blvd, Colorado Springs, CO 80907 | 2019-08-28 |
1366907123 | Natural Healthcare, LLC | Chiropractor | 3030 N Hancock Ave Suite D, Colorado Springs, CO 80907 | 2019-02-06 |
1063981777 | Samuel Ray Porterfield | Social Worker | Pfc Floyd K. Lindstrom Outpatient Clinic, 3141 Centennial Blvd., Colorado Springs, CO 80907 | 2018-11-26 |
1982170114 | A Physicians Home Care | Home Health | 905 W Garden of The Gods Rd Suite F, Colorado Springs, CO 80907 | 2018-10-15 |
1689196180 | Reena Annetta Manka | Counselor | 888 Garden of The Gods, 150, Colorado Springs, CO 80907 | 2017-07-17 |
1356870356 | Solaris Hc Co Inc | Hospice Care, Community Based | 1045 Garden of Gods Rd, Colorado Springs, CO 80907 | 2017-06-05 |
1649704826 | Colorado Springs Urological Associates Pllc | Urology | 1644 Medical Center Point, Suite 200, Colorado Springs, CO 80907 | 2017-04-14 |
1194274704 | Sarah Lynn Hartman | Dietitian, Registered | 3207 North Academy Blvd, Colorado, CO 80907 | 2016-09-23 |
Find all providers in zip 80907 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346421179 | John R. Burroughs Md PC | Surgery | 300 Garden of The Gods, Ste. 100, Colorado Springs, CO 80907 | 2007-11-20 |
1306129069 | Tad R. Heinz Md, PC | Surgery | 2960 N Circle Dr, Suite 115, Colorado Springs, CO 80909-1163 | 2011-09-20 |
1760703201 | Aaron D. Smith Md PC | Surgery | 5901 Corporate Dr, Colorado Springs, CO 80919-1941 | 2010-06-18 |
1871733998 | Mona Rane Md Chartered | Surgery | 1715 N Weber St, Suite 260, Colorado Springs, CO 80907-7532 | 2009-03-02 |
1780706986 | David D Dubois | Surgery | 2727 N Tejon St, Colorado Springs, CO 80907-6231 | 2007-04-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255970265 | Peak Plastic Surgery Center, PC | Surgery | 4500 E Cherry Creek South Dr Ste 425, Denver, CO 80246-1518 | 2019-12-23 |
1790004612 | Medvacation LLC | Surgery | 2340 Curtis Street Unit #3, Denver, CO 80205 | 2010-05-18 |
1336330653 | Dianne C. Leeb | Surgery | 31-n Wildflower Place, Edwards, CO 81632 | 2007-08-05 |
1013108299 | Richard Thomas Ethridge | Surgery | 1100 Poudre River Dr Unit A, Fort Collins, CO 80524-3557 | 2007-08-05 |
1891906996 | Thomas William Fawell | Surgery | 26781 E. Clifton Dr., Aurora, CO 80016 | 2007-05-24 |
1841322674 | Joyce Aycock | Surgery | 36 Steele St Ste 200, Denver, CO 80206-5710 | 2007-03-09 |
1811022239 | Steven Lee Snively | Surgery | 601 E Hampden Ave Ste 200, Englewood, CO 80113-2788 | 2007-02-23 |
1437231982 | Christine Maria Rodgers | Surgery | 4600 Hale Pkwy Ste 330, Denver, CO 80220-4000 | 2006-10-20 |
1871675314 | Michael Charles Bateman | Surgery | 4700 Hale Pkwy Ste 520, Denver, CO 80220-4053 | 2006-10-20 |
1902990237 | Cecilia Marie Franco-webb | Surgery | 5351 S Roslyn St Ste 100, Greenwood Village, CO 80111 | 2006-10-03 |
Find all providers with the same taxonomy |
City | COLORADO SPRINGS |
Zip Code | 80907 |
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.