POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1497368617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497368617 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
3116 Willett Dr Laramie WY 82072-5048 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 9702249102 |
| Practice Fax Number | 9702249112 |
| Mailing Telephone | 9702249102 |
| Mailing Fax Number | 9702249112 |
| 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 | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Pulmonology Clinic - Laramie | 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 |
3116 WILLETT DR |
| City | LARAMIE |
| State | WY |
| Zip Code | 82072-5048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831101609 | Kenneth L Robertson | Internal Medicine | 3116 Willett Dr, Laramie, WY 82072 | 2006-08-12 |
| 1174138705 | Poudre Valley Medical Group, LLC | Surgery | 3116 Willett Dr, Laramie, WY 82072-5048 | 2020-09-10 |
| 1558983577 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 3116 Willett Dr, Laramie, WY 82072-5048 | 2020-05-13 |
| 1205456035 | Poudre Valley Medical Group, LLC | Internal Medicine | 3116 Willett Dr, Laramie, WY 82072-5048 | 2020-04-22 |
| 1033628599 | Ivinson Memorial Hospital | Clinic/Center | 3116 Willett Dr, Laramie, WY 82072-5048 | 2017-09-27 |
| 1922441328 | Emma Marie Bjore | Family Medicine | 3116 Willett Dr, Laramie, WY 82072-5048 | 2013-04-16 |
| 1821329319 | Metwest Inc | Clinical Medical Laboratory | 3116 Willett Dr, Laramie, WY 82072-5048 | 2010-01-22 |
| 1881720514 | Intermountain Internal Medicine PC | Internal Medicine | 3116 Willett Dr, Laramie, WY 82072-5048 | 2007-02-26 |
| 1194812578 | Rebecca C Carron | Nurse Practitioner | 3116 Willett Dr, Laramie, WY 82072 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629688924 | Colby Wolf | 16th & Gibbon, Department 3414, Laramie, WY 82072 | 2020-08-03 | |
| 1871947341 | Curran Quast | Case Manager/Care Coordinator | 1465 N 4th St Ste 111, Laramie, WY 82072 | 2016-04-20 |
| 1184030827 | David Hokanson | Dentist | 352 N. 4th Street, Laramie, WY 82072 | 2014-07-02 |
| 1356673297 | Aaron Lozano | Counselor | 1465 N. 4th Street #119, Laramie, WY 82072 | 2010-02-03 |
| 1407181092 | Maureen K. Johnson Inc | In Home Supportive Care | 2010 Reynolds H280, Laramie, WY 82072 | 2009-10-15 |
| 1316120991 | Nephrology Clinic PC | Clinic/Center | 3116 Willet Dr, Laramie, WY 82072 | 2007-12-06 |
| 1851410682 | Laramie Reproductive Health | Public Health or Welfare | 1252 N 22nd St Suite A, Laramie, WY 82072 | 2007-03-29 |
| 1942345327 | Fike Chiropractic Pain Relief | Chiropractor | 1267 N 15th St, Suite 123b, Laramie, WY 82072 | 2007-02-21 |
| 1336215441 | Laramie Pediatrics Internal Medicine | Internal Medicine | 1252 North 22nd St, Ste B, Laramie, WY 82072 | 2006-11-28 |
| 1407939218 | Ark Regional Services, Inc | Occupational Therapist | 1150 N 3rd Street, Laramie, WY 82072 | 2006-10-23 |
| Find all providers in zip 82072 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1346288347 | Billings Clinic | Internal Medicine | 201 Yellowstone Ave, Cody, WY 82414-9313 | 2006-06-02 |
| 1225641442 | Poudre Valley Medical Group, LLC | Internal Medicine | 5050 Powderhouse Rd, Cheyenne, WY 82009-4800 | 2020-08-27 |
| 1013293745 | Campbell County Hospital District | Internal Medicine | 501 S Burma Ave, 3s-pulm, Gillette, WY 82716-3426 | 2011-10-26 |
| 1811130289 | Darryl Duane Bindschadler | Internal Medicine | 821 W Pershing Blvd, Cheyenne, WY 82001-2537 | 2009-04-14 |
| 1427250547 | Manish Aggarwal | Internal Medicine | 2301 House Ave, Suite 201, Cheyenne, WY 82001-3176 | 2007-06-01 |
| 1063517506 | Henry Kenneth Fisher | Internal Medicine | 1230 E 1st St, Casper, WY 82601-2704 | 2006-09-13 |
| 1922112531 | Muhammad Ammar Hussieno | Internal Medicine | 419 S Washington St, Suite 102, Casper, WY 82601-2951 | 2006-08-19 |
| 1295759660 | Casper Thoracic Medicine PC | Internal Medicine | 940 E 3rd St, Suite 207, Casper, WY 82601-3237 | 2006-07-27 |
| 1588691927 | Casper Thoracic Medicine, LLP | Internal Medicine | 940 E 3rd St, Suite 207, Casper, WY 82601-3237 | 2006-06-28 |
| 1154367845 | Steven D Reeb | Internal Medicine | 2301 House Ave, Ste 300, Cheyenne, WY 82001-3176 | 2006-06-21 |
| 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.