POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1588277701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588277701 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1750 E Ken Pratt Blvd Fl 3 Longmont CO 80504-5311 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7207183900 |
| Practice Fax Number | 7207180999 |
| Mailing Telephone | 7207183900 |
| Mailing Fax Number | 7207180999 |
| 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 - Longs Peak 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 |
1750 E KEN PRATT BLVD FL 3 |
| City | LONGMONT |
| State | CO |
| Zip Code | 80504-5311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124245543 | Sarah J Mckinley | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504 | 2007-04-19 |
| 1891300596 | Poudre Valley Medical Group, LLC | Surgery | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-09-10 |
| 1083227243 | Poudre Valley Medical Group, LLC | Pediatrics | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-08-27 |
| 1427678267 | Poudre Valley Medical Group, LLC | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2020-04-22 |
| 1619382496 | Kyle Jacob Thompson | Surgery | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2014-06-30 |
| 1952627473 | Maria Mildred Herrera | Internal Medicine | 1750 E Ken Pratt Blvd Fl 3, Longmont, CO 80504-5311 | 2010-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942776620 | Cinde S Yoho | Social Worker | 9485 County Road 15, Firestone, CO 80504 | 2018-10-19 |
| 1427544881 | Thousand Peaks Healthcare, Inc. | In Home Supportive Care | 310 Lashley St Ste 109, Longmont, CO 80504 | 2018-07-09 |
| 1962913962 | Melissa Frick | Counselor | 10184 E I-25 Frontage Rd, Firestone, CO 80504 | 2017-10-17 |
| 1558757260 | Firestone Pediatric Dentistry and Orthodontics | Dentist | 8301 Colorado Blvd, Suite 200, Firestone, CO 80504 | 2015-04-09 |
| 1912392671 | Ashley Lerwick | Speech-Language Pathologist | 11169 Interstate I25 Frontage Rd, Firestone, CO 80504 | 2015-03-31 |
| 1780077685 | Roger Leon Jorgensen | Ophthalmology | 14222 N 95 Si, Longmont, CO 80504 | 2015-03-17 |
| 1982942090 | Carrie Rose Fitzekam | Technician | 712 Tanagers Circle, Longmont, CO 80504 | 2013-01-24 |
| 1003166976 | Jennifer Lynn Mcnerney | Speech-Language Pathologist | 8197 Miller Dr, Frederick, CO 80504 | 2012-09-18 |
| 1821343450 | Allison Luellen | Physician Assistant | 8350 Colorado Blvd, Suite 160, Firestone, CO 80504 | 2012-07-19 |
| 1609132109 | Abby Elizabeth Bohall | Speech-Language Pathologist | 5132 Mt Buchanan Ave, Frederick, CO 80504 | 2012-04-09 |
| Find all providers in zip 80504 | ||||
| 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 |
|---|---|---|---|---|
| 1942813167 | Poudre Valley Medical Group, LLC | Internal Medicine | 1925 Mountain View Ave, Longmont, CO 80501-3128 | 2020-08-27 |
| 1215028543 | Longmont Pulmonary and Critical Care Associates, PC | Internal Medicine | 2030 Mountain View Ave, Suite 250, Longmont, CO 80501-3178 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712155 | Poudre Valley Medical Group, LLC | Internal Medicine | 940 Central Park Dr Ste 290, Steamboat Springs, CO 80487-8853 | 2020-08-27 |
| 1235627555 | Melanie Koenigshoff | Internal Medicine | 12605 E 16th Ave Rm 9014, Aurora, CO 80045-2545 | 2018-04-23 |
| 1598005266 | Richard O'brien | Internal Medicine | 422 Idlewild Dr, Dillon, CO 80435-8335 | 2013-02-18 |
| 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 |
| 1215228473 | Thomas Theodore Heacock | Internal Medicine | Uchealth Pulmonology Clinic, 2121 E Harmony Road Suite 300, Fort Collins, CO 80528-3403 | 2011-04-22 |
| 1730316464 | Peter D Sottile | Internal Medicine | 12700 E 19th Ave Rm 9023, Mail Stop C272, Aurora, CO 80045-2560 | 2009-06-20 |
| 1730377557 | Robert E. Benkert, Md PC | Internal Medicine | 9201 W 44th Ave, Unit B, Wheat Ridge, CO 80033-3084 | 2007-10-05 |
| 1487776530 | Eric Rich | Internal Medicine | 12700 E 19th Ave, Room 9c03, Aurora, CO 80045 | 2007-04-06 |
| 1326162330 | Rocky Mountain Pulmonary & Critical | Internal Medicine | 8550 W 38th Ave Ste 202, Wheat Ridge, CO 80033-4342 | 2007-03-16 |
| 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.