POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1437771722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437771722 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4110 Briargate Pkwy Ste 400 Colorado Springs CO 80920-7838 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193646550 |
| Practice Fax Number | 7193657668 |
| Mailing Telephone | 7193646550 |
| Mailing Fax Number | 7193657668 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| 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 Clinic - Memorial Hospital North | 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 |
4110 BRIARGATE PKWY STE 400 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-7838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499652 | Angela Renee Barajas | Nurse Practitioner | 4110 Briargate Pkwy Ste 400, Colorado Springs, CO 80920-7838 | 2019-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| 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 |
|---|---|---|---|---|
| 1316297104 | Edward Howe Wood | Internal Medicine | 8345 Westwood Rd, Colorado Springs, CO 80919-3244 | 2012-09-19 |
| 1174647671 | Ermel T Tansiongco | Internal Medicine | 2502 E Pikes Peak Ave Fl 3, Colorado Springs, CO 80909-6033 | 2007-03-19 |
| 1134260714 | Thomas W Sweatman IIi | Internal Medicine | 14336 Eagle Villa Grv, Colorado Springs, CO 80921-3200 | 2007-02-08 |
| 1316029069 | Parkside Cardiology LLC | Internal Medicine | 215 Parkside Drive, Colorado Springs, CO 80910 | 2006-10-20 |
| 1871537803 | David I Greenberg | Internal Medicine | 215 S Parkside Dr, Suite 215, Colorado Springs, CO 80910-3131 | 2006-06-16 |
| 1568450369 | Cindy L Wickline | Internal Medicine | 1849 Austin Bluffs Pkwy, Ste 100, Colorado Springs, CO 80918-7843 | 2005-10-06 |
| 1336136340 | Robert A. Cadigan | Internal Medicine | 4863 N Nevada Ave, Colorado Springs, CO 80918-3951 | 2005-10-04 |
| 1972508505 | Pamela Ann Taylor | Internal Medicine | 6011 E Woodmen Rd, Ste 120, Colorado Springs, CO 80923-2603 | 2005-06-20 |
| 1962407502 | Paul David Sherry | Internal Medicine | 6011 E Woodmen Rd Ste 105, Colorado Springs, CO 80923-2603 | 2005-06-20 |
| 1649887787 | Poudre Valley Medical Group, LLC | Internal Medicine | 5818 N Nevada, Suite 225, Colorado Springs, CO 80918 | 2020-09-23 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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.