POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1548875677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548875677 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
525 Bob Peters Grv Ste 302 Colorado Springs CO 80909-4533 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193655445 |
| Practice Fax Number | 7193655530 |
| Mailing Telephone | 7193655445 |
| Mailing Fax Number | 7193655530 |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |
| 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 | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Thoracic Surgery - Memorial Hospital Central | 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 |
525 BOB PETERS GRV STE 302 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80909-4533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487863700 | Crystal Joy Erickson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 525 Bob Peters Grv Ste 302, Colorado Springs, CO 80909-4533 | 2007-05-22 |
| 1134741242 | Poudre Valley Medical Group, LLC | Internal Medicine | 525 Bob Peters Grv Ste 302, Colorado Springs, CO 80909-4533 | 2020-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376173765 | Ascent Health LLC | Community/Behavioral Health | 2608 Palmer Park Blvd., Colorado Springs, CO- COLORADO 80909 | 2020-01-24 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| 1437706231 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 445 N Circle Drive, Colorado Springs, CO 80909 | 2019-08-26 |
| 1760952964 | James Garofalo | Counselor | 2210 E La Salle St Ste 221, Colorado Spgs, CO 80909 | 2018-11-29 |
| 1144719055 | Autumn Leaves Counseling, LLC | Counselor | 2130 Academy Circle, Suite B, Co Springs, CO 80909 | 2018-05-07 |
| 1407353642 | Ambulnz Co, LLC | Ambulance | 2420 E Pikes Peak Ave Ste 1001, Colorado Springs, CO 80909 | 2018-04-12 |
| 1083117998 | Peak Wellness Counseling Service, LLC | Counselor | 2210 E. La Salle Street, Suite 208, Colorado Springs, CO 80909 | 2018-03-16 |
| 1043740822 | Ande Carol West | Dental Hygienist | 701 Citadel Drive East, Colorado Springs, CO 80909 | 2017-06-14 |
| 1043748791 | Colorado Springs Pharmacy LLC | Pharmacy | 2224 E. Pikes Peak Ave, Colorado Springs, CO 80909 | 2017-05-25 |
| 1215484365 | Brittney Nicole Roberts | Physical Therapist | 2201 Lelaray St., Colorado Springs, CO 80909 | 2016-09-07 |
| Find all providers in zip 80909 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710208202 | Paul Franklin Eckstein | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 22 West Cheyenne Mountain Blvd, Colorado Springs, CO 80906-4335 | 2010-06-18 |
| 1487863700 | Crystal Joy Erickson | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 525 Bob Peters Grv Ste 302, Colorado Springs, CO 80909-4533 | 2007-05-22 |
| 1053368977 | Catholic Health Initiatives Colorado | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2222 N. Nevada Avenue, Suite 5011, Colorado Springs, CO 80907 | 2006-05-27 |
| 1629072228 | Martin Lynn Beggs | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 525 N Foote Ave, Ste 302, Colorado Springs, CO 80909-4501 | 2005-06-10 |
| 1518596774 | Poudre Valley Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1400 E Boulder St Ste 700, Colorado Springs, CO 80909-5533 | 2020-04-08 |
| 1831666452 | Specialty Medcare Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2222 N Nevada Ave Ste 5011, Colorado Springs, CO 80907-6819 | 2018-11-01 |
| 1770915043 | Catholic Health Initiatives Colorado | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2222 N Nevada Ave Ste 5010, Colorado Springs, CO 80907 | 2013-08-08 |
| 1356783351 | Catholic Health Initiatives Colorado | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2222 N Nevada Ave, Suite 5011, Colorado Springs, CO 80907-6819 | 2013-07-19 |
| 1316265705 | Memorial Health System | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 175 S Union Blvd, #115, Colorado Springs, CO 80910-3113 | 2010-05-10 |
| 1467611996 | Tyler Cooley Spata | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2222 N Nevada Ave Ste 5011, Colorado Springs, CO 80907 | 2008-06-09 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80909 |
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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.