POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1912516485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912516485 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
100 Cook Street Suite 402 Denver CO 80206 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7205169415 |
| Practice Fax Number | 7205169443 |
| Mailing Telephone | 7205169415 |
| Mailing Fax Number | 7205169443 |
| 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 | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Neurology 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 402 |
| 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 |
| 1821607391 | Poudre Valley Medical Group, LLC | Surgery | 100 Cook Street, Suite 306, 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 | 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 |
|---|---|---|---|---|
| 1902377179 | Para Health, LLC | Psychiatry & Neurology | 1091 E Bayaud Ave Apt W2604, Denver, CO 80209-2783 | 2018-12-16 |
| 1558715516 | Tara Celeste Carlisle | Psychiatry & Neurology | 3055 Roslyn St Unit 120, Denver, CO 80238-3324 | 2016-04-15 |
| 1346679826 | Michael A. Ament, M.d., Pllc | Psychiatry & Neurology | 4622 W Moncrieff Pl, Denver, CO 80212-1604 | 2013-11-05 |
| 1235484684 | Cherry Creek Neurology | Psychiatry & Neurology | 1720 S. Bellaire St. Ste 200, Denver, CO 80222 | 2012-07-20 |
| 1043538085 | Susan Patrice Anzalone | Psychiatry & Neurology | 1873 S Bellaire St Ste 620, Denver, CO 80222-4353 | 2010-05-15 |
| 1710140017 | Lawrence P Scibilia | Psychiatry & Neurology | 1660 S Albion St Ste 425, Denver, CO 80222 | 2008-07-07 |
| 1023207941 | Neurovision PC | Psychiatry & Neurology | 3480 S Galena St, 4b, Denver, CO 80231-5504 | 2007-10-16 |
| 1063567477 | Advanced Neurological Evaluation and Treatment Center PC | Psychiatry & Neurology | 1721 E 19th Ave Ste 510, Denver, CO 80218-1243 | 2007-01-24 |
| 1639227564 | David Seymour Madison | Psychiatry & Neurology | 2525 So Downing, Porter Hosp, Denver, CO 80210 | 2007-01-08 |
| 1215019609 | Justin Suk Joo Moon | Psychiatry & Neurology | 950 E Harvard Ave Ste 570, Denver, CO 80210 | 2006-10-19 |
| Find all providers in DENVER | ||||
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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.