POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1861021008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861021008 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
1725 E Boulder St Ste 101 Colorado Springs CO 80909-5740 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193656300 |
| Practice Fax Number | 7193656094 |
| Mailing Telephone | 7193656300 |
| Mailing Fax Number | 7193656094 |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2020-04-08 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Brain and Spine Clinic - Colorado Springs | 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 |
1725 E BOULDER ST STE 101 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80909-5740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598755092 | Christopher Steven Williams | Psychiatry & Neurology | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2005-10-26 |
| 1780297366 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2020-08-25 |
| 1831711704 | Poudre Valley Medical Group, LLC | Psychiatry & Neurology | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2020-05-13 |
| 1003370230 | Kimberly M Atwater | Physician Assistant | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2019-01-22 |
| 1851874150 | Jace Michael Waguspack | Clinical Neuropsychologist | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2018-09-12 |
| 1811447451 | Madeline Lusk | Physician Assistant | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909 | 2016-10-06 |
| 1487933586 | Julie Elizabeth Horwitz | Clinical Neuropsychologist | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909 | 2011-08-08 |
| 1407159874 | Jeanette Baumann | Registered Nurse | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2010-12-07 |
| 1801026992 | Krista N Greenan | Neurological Surgery | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2009-07-23 |
| 1104081637 | Chamisa Macindoe | Emergency Medicine | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909 | 2008-07-24 |
| Find all providers in the same location | ||||
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194340414 | Northstar Neurology of Colorado Springs PC | Psychiatry & Neurology | 3920 N Union Blvd Ste 150, Colorado Springs, CO 80907-1907 | 2020-06-11 |
| 1518478692 | Grabert Health, LLC | Psychiatry & Neurology | 7871 Dutchrock Rd, Colorado Springs, CO 80919-3893 | 2017-10-17 |
| 1265601645 | Patricia A. Fodor, M.d. P.C. | Psychiatry & Neurology | 7606 N. Union, Suite G, Colorado Springs, CO 80920 | 2008-02-29 |
| 1295916989 | Colorado Center for Neuroscience, PC | Psychiatry & Neurology | 1715 N Weber St # 100, Colorado Springs, CO 80907-7524 | 2007-11-21 |
| 1346324746 | Bradley J Davis | Psychiatry & Neurology | 8715 Massey Cir, Colorado Springs, CO 80920-7127 | 2006-10-24 |
| 1255425831 | Cynthea I Blake | Psychiatry & Neurology | 3010 N. Circle Drive Suite 120, Colorado Springs, CO 80209 | 2006-10-03 |
| 1700994423 | Lawrence C Wang | Psychiatry & Neurology | 3245 International Cir Ste 103, Colorado Springs, CO 80910-3152 | 2006-08-25 |
| 1518992155 | Thomas E. Bowser Md Pllc | Psychiatry & Neurology | 8540 Scarborough Drive Ste 390, Colorado Springs, CO 80920-7519 | 2006-07-12 |
| 1356399448 | Kevin R Scott | Psychiatry & Neurology | 1400 E Boulder St Ste 700, Colorado Springs, CO 80909-5533 | 2006-05-04 |
| 1598755092 | Christopher Steven Williams | Psychiatry & Neurology | 1725 E Boulder St Ste 101, Colorado Springs, CO 80909-5740 | 2005-10-26 |
| 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.