POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1538790704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538790704 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1000 Pole Creek Xing Sidney NE 69162-2901 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 3082548525 |
| Practice Fax Number | 3082544003 |
| Mailing Telephone | 3082548525 |
| Mailing Fax Number | 3082544003 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |
| 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 Outreach - Sidney | Doing Business As Name - 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 |
1000 POLE CREEK XING |
| City | SIDNEY |
| State | NE |
| Zip Code | 69162-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730187386 | Kolette L Smith | Internal Medicine | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2005-07-08 |
| 1740895952 | Cheyenne County Hospital Association Inc | Pharmacy | 1000 Pole Creek Xing, Sidney, NE 69162-2900 | 2020-09-14 |
| 1003447194 | Sabra D Peetz | Physician Assistant | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2020-01-28 |
| 1124594163 | Stacey Mitlehner | Physical Therapy Assistant | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2018-10-17 |
| 1265914014 | Emily Johnson | Pharmacist | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2018-08-29 |
| 1497234926 | John Patrick Mildenberger | Pharmacist | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2018-08-07 |
| 1619405263 | Kory Krahl | Nurse Anesthetist, Certified Registered | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2017-05-26 |
| 1295270346 | Nathaniel Clark | Nurse Anesthetist, Certified Registered | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2016-12-28 |
| 1821543372 | Andrew Stieb | Physician Assistant | 1000 Pole Creek Xing, Sidney, NE 69162-2901 | 2016-08-24 |
| 1396192324 | Jamie Rezac | Occupational Therapist | 1000 Pole Creek Xing, Rehabilitation, Sidney, NE 69162-2901 | 2016-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992192207 | Sheila Howard | Counselor | 1516 1/2 10th Ave, Sidney, NE 69162 | 2015-04-24 |
| 1801027479 | James Allen Grosshans | Nurse Anesthetist, Certified Registered | 645 Osage, Memorial Health Center, Sidney, NE 69162 | 2009-07-30 |
| 1386704252 | Nancy Kay Bradford | Counselor | 1023 10th Avenue, Sidney, NE 69162 | 2006-12-11 |
| 1861585200 | Western Drug Co | Durable Medical Equipment & Medical Supplies | 806 Illinios, Sidney, NE 69162 | 2006-09-30 |
| 1518070507 | David J Peckham | Dentist | 1133 Jackson, Sidney, NE 69162 | 2006-08-16 |
| 1578571527 | Carl John Cornelius Jr. | Family Medicine | 1116 10th Avenue, Sidney, NE 69162 | 2006-08-04 |
| 1992130751 | Kristen E Rose | Counselor | 1000 Pole Creek Crossing, Sidney, NE 69162 | 2013-09-11 |
| 1366504367 | Debra Jean Loveless | Counselor | 1023 10th Avenue, Sidney, NE 69162 | 2006-12-15 |
| 1376504357 | Stephanie L Green | Nurse Practitioner | 1000 Pole Creek Xing Ste 1, Sidney, NE 69162 | 2006-03-30 |
| 1528330099 | Tara Rachel Turner | Licensed Practical Nurse | 1929 Dodge St, Sidney, NE 69162-1042 | 2012-01-31 |
| Find all providers in zip 69162 | ||||
| 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 |
|---|---|---|---|---|
| 1801908553 | Rani Kapur-pado | Internal Medicine | 43 Pearl Street, 2nd Fl Suite 1a Rani Kapur-pado Do LLC, Sidney, NY 13838 | 2006-08-31 |
| 1497741409 | Randall Corey Orem | Internal Medicine | 1103 Fairington Dr, Sidney, OH 45365-8130 | 2005-09-26 |
| 1922630276 | Poudre Valley Medical Group, LLC | Internal Medicine | 1625 Dorwart Dr, Sidney, NE 69162-2505 | 2020-02-05 |
| 1952675142 | Lmh Heart Institute of Northwest Ohio, LLC | Internal Medicine | 915 Michigan St, Suite 204, Sidney, OH 45365-2401 | 2012-03-06 |
| 1659542322 | Randall C Orem Do Inc | Internal Medicine | 1103 Fairington Dr, Sidney, OH 45365-8130 | 2008-03-20 |
| 1962598045 | Gelder Medical Pllc | Internal Medicine | 44 Pearl Street, Gelder Medical Group, Sidney, NY 13838 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750903068 | Matrix Medical Network of Nebraska PC | Internal Medicine | 233 S 13th St Ste 1900, Lincoln, NE 68508-2000 | 2020-05-08 |
| 1700417391 | Poudre Valley Medical Group, LLC | Internal Medicine | 2 W 42nd St Ste 2200, Scottsbluff, NE 69361-4669 | 2020-02-01 |
| 1467906487 | Arif Ishaq Albulushi | Internal Medicine | 9011 Burt St, Apt 106, Omaha, NE 68114-2477 | 2016-08-08 |
| 1578796207 | Krishna Naag Velagapudi | Internal Medicine | 110 N 29th St Ste 301, Norfolk, NE 68701-4466 | 2009-08-28 |
| 1639333883 | James N Karnegis | Internal Medicine | 20975 Bonanza Blvd, Elkhorn, NE 68022-1838 | 2008-07-16 |
| 1780725580 | Richard James Markiewicz | Internal Medicine | 601 W Leota St., North Platte, NE 69101 | 2007-02-12 |
| 1912055112 | Hemantha Kumar Koduri | Internal Medicine | 4445 S 86th St Ste 100, Lincoln, NE 68526 | 2007-01-06 |
| 1316025505 | Robert Lee Percell Jr. | Internal Medicine | 1600 S 48th St Ste 600, Lincoln, NE 68506-1275 | 2006-11-02 |
| 1861503427 | Antonio P Reyes | Internal Medicine | 4239 Farnam St Ste 100, Omaha, NE 68131-2858 | 2006-08-31 |
| 1184739989 | Dennis J Esterbrooks | Internal Medicine | 2412 Cuming St, Omaha, NE 68131-1601 | 2006-08-20 |
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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.