POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1558970020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558970020 |
Entity Type | Organization |
Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
Practice Address |
100 Cook Street Suite 400 Denver CO 80206 |
Practice Telephone | 7205169421 |
Practice Fax Number | 7205169449 |
Mailing Telephone | 7205169421 |
Mailing Fax Number | 7205169449 |
Enumeration Date | 2020-07-30 |
Last Update Date | 2020-07-30 |
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 - Cherry Creek | 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 |
100 COOK STREET SUITE 400 |
City | DENVER |
State | CO |
Zip Code | 80206 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194776898 | Mara Mindy Isser Sax | Physical Medicine & Rehabilitation | 100 Cook Street, Suite 402, Denver, CO 80206 | 2006-05-15 |
1487251948 | University of Colorado Hospital Authority | Clinical Medical Laboratory | 100 Cook Street, Room 2 062, Denver, CO 80206-5322 | 2020-10-07 |
1720697295 | Poudre Valley Medical Group, LLC | Internal Medicine | 100 Cook Street, Suite 408, Denver, CO 80206 | 2020-07-30 |
1538778006 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 100 Cook Street, Suite 402, Denver, CO 80206 | 2020-07-30 |
1922617497 | Poudre Valley Medical Group, LLC | Internal Medicine | 100 Cook Street, Suite 412, Denver, CO 80206 | 2020-07-30 |
1679182141 | Poudre Valley Medical Group, LLC | Internal Medicine | 100 Cook Street, Suite 202, Denver, CO 80206 | 2020-07-30 |
1396354866 | Poudre Valley Medical Group, LLC | Internal Medicine | 100 Cook Street, Suite 408, Denver, CO 80206 | 2020-07-30 |
1205445772 | Poudre Valley Medical Group, LLC | Dermatology | 100 Cook Street, Suite 306, Denver, CO 80206 | 2020-07-30 |
1194334664 | Poudre Valley Medical Group, LLC | Orthopaedic Surgery | 100 Cook Street, Suite 406, Denver, CO 80206 | 2020-07-30 |
1912516485 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 100 Cook Street, Suite 402, Denver, CO 80206 | 2020-07-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609495373 | Mindy Lieberman | Behavior Technician | 1151 Monroe St. #2, Denver, CO 80206 | 2020-04-13 |
1356992879 | Danielle Higgins | Counselor | 3003 E 3rd Ave # B-106, Denver, CO 80206 | 2019-09-25 |
1396224788 | Neuro Interpretive Services LLC | Clinic/Center | 700 Colorado Blvd Ste 668, Denver, CO 80206 | 2018-08-07 |
1578072252 | Ashleigh Rankin | Social Worker | 1890 Gaylord Street, Denver, CO 80206 | 2017-09-25 |
1407379092 | Todd C. Ognibene | Psychologist | 1544 York Street, Third Floor, Denver, CO 80206 | 2017-07-25 |
1104363811 | Zhanna Bayerman | In Home Supportive Care | 3222 E. 1st Ave, # 725, Denver, CO 80206 | 2017-01-20 |
1467995340 | Julie Huff | Massage Therapist | 155 Cook, 351, Denver, CO 80206 | 2016-11-28 |
1457807778 | Amrita Singh Comer | Nursing Care | 2111 Champa Street, Denver, CO 80206 | 2016-08-28 |
1245683952 | Emily Rose Popiel | Psychologist | 3107 East Colfax Avenue, Denver, CO 80206 | 2016-07-18 |
1689036998 | Emma Jean Maki-gianani | Counselor | 2925 E. Colfax, Denver, CO 80206 | 2016-03-25 |
Find all providers in zip 80206 |
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 |
---|---|---|---|---|
1417208257 | Timothy C Kennedy Md LLC | Internal Medicine | 2045 Ash St, Denver, CO 80207-3717 | 2012-09-19 |
1659662484 | Kent Lee Christopher | Internal Medicine | 9086 E Colorado Cir, Denver, CO 80231-2924 | 2011-04-27 |
1720178403 | Michael J Gerber | Internal Medicine | 4200 E Ninth Ave, Denver, CO 80262-0001 | 2006-10-13 |
1649369638 | Healthone Clinic Services LLC | Internal Medicine | 1609 E 19th Ave, Suite 3550, Denver, CO 80218-1285 | 2006-10-11 |
1205942745 | John Edward Buckley | Internal Medicine | 51 West 84th Ave, Suite 210, Denver, CO 80260-4882 | 2006-08-21 |
1760485023 | Robert J Lapidus | Internal Medicine | 1400 Jackson St, Denver, CO 80206-2761 | 2005-05-31 |
1659784890 | Catawba Valley Medical Group, Inc | Internal Medicine | 6127 Highway 16 S, Denver, NC 28037-9220 | 2014-06-05 |
1609019751 | Ann M Granchelli | Internal Medicine | 1400 Jackson St, Denver, CO 80206-2761 | 2009-04-18 |
1568639839 | Silpa Dhoma Krefft | Internal Medicine | 1400 Jackson St, Denver, CO 80206-2761 | 2008-05-14 |
1417134883 | Kendra Marie Hammond | Internal Medicine | 1400 Jackson St, Denver, CO 80206-2761 | 2008-01-28 |
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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.