POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1699388934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699388934 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4840 Larimer Pkwy Bldg 1 Johnstown CO 80534-9012 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 3038412212 |
| Practice Fax Number | 3038414716 |
| Mailing Telephone | 3038412212 |
| Mailing Fax Number | 3038414716 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| 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 | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Primary Care - Johnstown | 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 |
4840 LARIMER PKWY BLDG 1 |
| City | JOHNSTOWN |
| State | CO |
| Zip Code | 80534-9012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508055641 | Kristi Lynn Paetzel | Physician Assistant | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2007-10-15 |
| 1396350690 | Poudre Valley Medical Group, LLC | Clinic/Center | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2020-09-14 |
| 1336516665 | Brittany Hunter | Physician Assistant | 4840 Larimer Pkwy Bldg 1, Johnstown, CO 80534-9012 | 2015-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790299410 | Bauer Occupational Therapy, LLC | Occupational Therapist | 442 La Costa Ln, Johnstown, CO 80534 | 2017-11-17 |
| 1942698071 | Family Physicians of Greeley, LLP | Family Medicine | 473 Castle Pines Ave, Suite 1, Johnstown, CO 80534 | 2014-12-23 |
| 1376761924 | Steven L Martin | Dentist | 5 N. Parish Ave., Johnstown, CO 80534 | 2007-04-20 |
| 1699896613 | Ashlea Elizabeth Franques | Pediatrics | 4435 Ronald Reagan Blvd, Johnstown, CO 80534 | 2007-04-03 |
| 1720069198 | Kenneth A Pettine | Orthopaedic Surgery | 4795 Larimer Parkway, Johnstown, CO 80534 | 2005-11-10 |
| 1043858251 | Kristen Mcfarland | Physical Therapist | 247 Mountain Avenue, Berthoud, CO 80534 | 2019-12-18 |
| 1841780400 | Colorado Rehabilitation Associates LLC | Physical Medicine & Rehabilitation | 4401 Union St, Johnstown, CO 80534 | 2018-05-18 |
| 1073059523 | Santibanez Aguirre PC | Hospitalist | 4401a Union Street, Johnstown, CO 80534 | 2017-01-09 |
| 1811142524 | 25/34 Plastic Surgery Associates, PC | Specialist | 4450 Union St., Suite 100, Johnstown, CO 80534-0001 | 2008-11-21 |
| 1790794824 | Marc Anthony Masotti | Internal Medicine | 4401a Union St, Johnstown, CO 80534-2800 | 2006-08-07 |
| Find all providers in zip 80534 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699290411 | Rg Vargo Do Inc | Family Medicine | 738 W Coshocton St, Johnstown, OH 43031-9581 | 2017-08-14 |
| 1972957132 | Travis Rearick | Family Medicine | 1450 Scalp Ave # 3b, Johnstown, PA 15904-3321 | 2016-04-14 |
| 1598025801 | Prerana Bhupendrakumar Patel | Family Medicine | 1 Tech Park Dr Ste 1130, Johnstown, PA 15901-2517 | 2012-05-21 |
| 1043582406 | Bonifacio Tan Aguilera | Family Medicine | 307 Terlyn Drive, Johnstown, PA 15904 | 2012-02-01 |
| 1871814624 | Richard Adam Wagner | Family Medicine | 295 County Hwy. 156, Johnstown, NY 12095-4123 | 2010-06-16 |
| 1720240112 | Jimmy Pyakurel | Family Medicine | 334 Bloomfield St Ste 205, Johnstown, PA 15904-3269 | 2008-06-27 |
| 1205007820 | Conemaugh Health Initiatives | Family Medicine | 338 Bloomfield St, Johnstown, PA 15904-3272 | 2008-03-24 |
| 1144369869 | Carol E. Kowtoniuk | Family Medicine | 226 Fairfield Ave, Johnstown, PA 15906-2310 | 2007-02-06 |
| 1861531766 | Sharon Marie Plank | Family Medicine | 1450 Scalp Ave Ste 1000, Johnstown, PA 15904-3335 | 2007-02-06 |
| 1942399134 | Cara E. Brown | Family Medicine | 473 Castle Pines Ave Ste 1, Johnstown, CO 80534-7859 | 2006-10-12 |
| Find all providers in JOHNSTOWN | ||||
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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.