POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1467065680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467065680 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1024 S Lemay Ave Fort Collins CO 80524-3929 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9704957000 |
| Mailing Telephone | 9704957000 |
| Enumeration Date | 2020-08-27 |
| Last Update Date | 2020-08-27 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Regional Neuroscience Center - Poudre Valley 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 |
1024 S LEMAY AVE |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80524-3929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487659181 | Dennis P. Brant | Emergency Medicine | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2005-06-17 |
| 1164021911 | Poudre Valley Medical Group, LLC | Social Worker | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-10-22 |
| 1710593611 | Poudre Valley Medical Group, LLC | Registered Nurse | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-09-17 |
| 1902419120 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-08-27 |
| 1356953939 | Denise Patten | Pharmacist | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-08-17 |
| 1609484302 | Poudre Valley Medical Group, LLC | Internal Medicine | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-07-20 |
| 1396369492 | Whitney Raye Pollard | Counselor | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-06-04 |
| 1922620897 | Poudre Valley Medical Group, LLC | General Practice | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-05-13 |
| 1134740913 | Haley R Rider | Speech-Language Pathologist | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-05-03 |
| 1831722099 | Kelly Smith | Social Worker | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2020-02-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669084612 | Summitstone Health Partners | Clinic/Center | 1008 Patton St., Fort Collins, CO 80524 | 2020-08-20 |
| 1396355244 | Kidstuff Child and Family Counseling, P.C. | Psychologist | 1006 Robertson St., Ste. 120, Fort Collins, CO 80524 | 2020-08-05 |
| 1215561857 | Transform The Nest LLC | Social Worker | 405 A Matthews Street, Fort Collins, CO 80524 | 2020-02-22 |
| 1326671413 | Laura Ann Doyle | Registered Nurse | 8775 County Road 80.5 # 5, Fort Collins, CO 80524 | 2020-02-17 |
| 1013496835 | Stepheny Nicol Chapple | Psychologist | 701 S College Drive, 201, Fort Collins, CO 80524 | 2018-08-13 |
| 1609372432 | Tracy Jo Close | Counselor | 1031 Robinson Street, Fort Collins, CO 80524 | 2018-04-02 |
| 1831617828 | Rachel Elizabeth Brenner | Counselor | 151 W Lake Rd, Csu Health Network Counseling Services, Fort Collins, CO 80524 | 2017-08-30 |
| 1205366820 | Victoria Marie Sechser | Specialist/Technologist | 1102 Peterson St, Fort Collins, MN 80524 | 2017-06-15 |
| 1013367705 | Smith Street LLC | Day Training, Developmentally Disabled Services | 308 Smith St., Fort Collins, CO 80524 | 2016-06-14 |
| 1811344989 | Ignite Speech-language Services | Clinic/Center | 3921 Celtic Lane, Fort Collins, CO 80524 | 2016-05-18 |
| Find all providers in zip 80524 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
| 1629136254 | Gerald C Mcintosh Md | Psychiatry & Neurology | 1221 E Elizabeth St, Suite 3, Fort Collins, CO 80524-4065 | 2006-12-05 |
| 1124087937 | Donald A Golen | Psychiatry & Neurology | 2315 E Harmony Rd Ste 110, Fort Collins, CO 80528-8623 | 2006-03-21 |
| 1164425898 | Timothy J. Allen | Psychiatry & Neurology | 2121 E Harmony Rd # 270, Fort Collins, CO 80528-3402 | 2005-05-26 |
| 1710980610 | Michael P Curiel | Psychiatry & Neurology | 1106 E Prospect Rd, Suite 100, Fort Collins, CO 80525-5304 | 2005-05-24 |
| 1205458221 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 2315 E Harmony Rd Ste 110, Fort Collins, CO 80528-8623 | 2020-05-13 |
| 1831574722 | Sean T Pauzauskie | Psychiatry & Neurology | 1024 S Lemay Ave, Fort Collins, CO 80524-3929 | 2015-07-21 |
| 1427436377 | Janae Dupuis | Psychiatry & Neurology | 2315 E Harmony Rd Ste 110, Fort Collins, CO 80528-8623 | 2015-05-12 |
| 1972829737 | Brenda Marie George | Psychiatry & Neurology | 2315 E Harmony Rd, Suite 110, Fort Collins, CO 80528-8620 | 2010-04-19 |
| 1801044722 | William R. Shaffer | Psychiatry & Neurology | 2315 E Harmony Rd, Suite 110, Fort Collins, CO 80528-8620 | 2008-09-04 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80524 |
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.