POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1821607391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821607391 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
100 Cook Street Suite 306 Denver CO 80206 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7205169400 |
| Practice Fax Number | 7205169428 |
| Mailing Telephone | 7205169400 |
| Mailing Fax Number | 7205169428 |
| 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 | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Plastic and Reconstructive Surgery 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 306 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255970265 | Peak Plastic Surgery Center, PC | Surgery | 4500 E Cherry Creek South Dr Ste 425, Denver, CO 80246-1518 | 2019-12-23 |
| 1790004612 | Medvacation LLC | Surgery | 2340 Curtis Street Unit #3, Denver, CO 80205 | 2010-05-18 |
| 1841322674 | Joyce Aycock | Surgery | 36 Steele St Ste 200, Denver, CO 80206-5710 | 2007-03-09 |
| 1437231982 | Christine Maria Rodgers | Surgery | 4600 Hale Pkwy Ste 330, Denver, CO 80220-4000 | 2006-10-20 |
| 1871675314 | Michael Charles Bateman | Surgery | 4700 Hale Pkwy Ste 520, Denver, CO 80220-4053 | 2006-10-20 |
| 1447748496 | Plastic & Reconstructive Institute of Denver LLC | Surgery | 1601 E 19th Ave Ste 3650, Denver, CO 80218-1282 | 2018-04-25 |
| 1003220849 | Cassandra Alys Ligh | Surgery | 2045 N Franklin St, Denver, CO 80205-5437 | 2014-06-19 |
| 1417265596 | Emmett Plastic Surgery, Pllc | Surgery | 3773 Cherry Creek North Dr, Denver, CO 80209-3804 | 2010-09-22 |
| 1861716540 | Corrine Wong | Surgery | 777 Bannock St, Denver, CO 80204-4507 | 2010-03-24 |
| 1750547824 | David P Schnur Mdpc | Surgery | 1601 E 19th Ave, Suite 5150, Denver, CO 80218-1216 | 2008-07-29 |
| Find all providers in DENVER | ||||
Please comment or provide details below to improve the information on POUDRE VALLEY MEDICAL GROUP, LLC.
| 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.