Poudre Valley Open MRI, LLC

Primary specialty

Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X

Legal business name

POUDRE VALLEY OPEN MRI, LLC

Practice address

2420 E Prospect Rd
Fort Collins, CO 80525-9729

Phone

(970) 493-0567

NPI assigned

May 27, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael P Belick

Title

C.E.O.

Phone

(415) 884-3096

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1023065844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6102",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949486102",
            "telephone_number": "415-884-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 E PROSPECT RD",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805259729",
            "telephone_number": "970-493-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY OPEN MRI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "BELICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "415-884-3096"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00080903",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81833237",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Poudre Valley Medical Group, LLC
• Poudre Valley Periodontics & Dental Implants
• Poudre Valley Radiation Oncology LLC
• Elaine Marie Poulin, PHD
• Matthew David Pouliot, D.O.
• Anne Karen Poulson, MA, MED, LPC, NCC

• Magnetic Resonance Imaging (MRI) Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Magnetic Resonance Imaging (MRI) Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.