Poudre Valley Medical Group, LLC
Organization Active NPI Family Medicine Physician · Berthoud, CO
NPI 1043039043 · NPPES record last updated Nov 19, 2024
Key facts
- NPI
- 1043039043
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- POUDRE VALLEY MEDICAL GROUP, LLC
- Practice address
- 1335 Grand Market Ave Unit 110
Berthoud, CO 80513-2779 - Phone
- (970) 674-4920
- NPI assigned
- Oct 7, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
- Name
- Jana Conroy
- Title
- Director of Credentialing
- Phone
- (970) 674-4920
Corporate family (same tax ID) 19
Practitioners 1
-
James McCarrey, DO
National Provider Directory
- Tax ID family
- Poudre Valley Medical LLC
- Part of
- Poudre Valley Medical LLC
Locations
1335 Grand Market Ave
Berthoud, CO 80513
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
1335 Grand Market Ave Unit 110
Berthoud, CO 80513-2779
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Other names
- UCHealth Medical Group
- UCHealth Primary Care - Berthoud
Other providers in Berthoud, CO
- New Paradigm Medical, PC
- Melissa Diane Ott
- Owens Dental Berthoud, P.C.
- Katherine Breanne Patrick
- Brenda Lynn Peacock
- Kylea Ginger Rickard
- Amanda Lee Roland
- Kimberly Rousseau-Simmons
- Sarah Santefort
- Kerri Schleiger
All providers in Berthoud, CO · Family Medicine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.