Poudre Valley Medical Group, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

POUDRE VALLEY MEDICAL GROUP, LLC

Doing business as

UCHealth Medical Group

Practice address

16222 W US Highway 24 Ste 220
Woodland Park, CO 80863-8763

Phone

(719) 653-2960

Fax

(719) 374-6212

NPI assigned

Sep 10, 2020

Last updated

Oct 24, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

POUDRE VALLEY MEDICAL GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Jana Conroy

Title

Director of Credentialing

Phone

(719) 365-2960

Specialties & licenses 13

Addresses

Other names 1

• UCHealth Medical Group Doing business as

Tax ID family

Poudre Valley Medical LLC283 organizations share this tax ID, including this one

Part of

Poudre Valley Medical LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Family Medicine Physician
  • Berthoud, CO
  • NPI 1043039043
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Surgery Physician
  • Highlands Ranch, CO
  • NPI 1053276261
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Obstetrics & Gynecology Physician
  • Colorado Springs, CO
  • NPI 1063027159
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Gastroenterology Physician
  • Fort Collins, CO
  • NPI 1063042687
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Family Medicine Physician
  • Denver, CO
  • NPI 1063176055
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Psychiatry Physician
  • Pueblo, CO
  • NPI 1063209534
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Surgery Physician
  • Fort Collins, CO
  • NPI 1063290203
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Gastroenterology Physician
  • Highlands Ranch, CO
  • NPI 1083365613
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Neurology Physician
  • Loveland, CO
  • NPI 1083433098
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Radiation Oncology Physician
  • Colorado Springs, CO
  • NPI 1104439322
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Family Medicine Physician
  • Littleton, CO
  • NPI 1104675792
  NPD tax ID
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • Family Medicine Physician
  • Denver, CO
  • NPI 1114530466
  NPD tax ID

Locations

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1114532801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16222 W US HIGHWAY 24 STE 220",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808638763",
            "telephone_number": "719-653-2960",
            "fax_number": "719-374-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "enumeration_date": "2020-09-10",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "719-365-2960"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UCHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Physician in Woodland Park, CO
• Providers in Woodland Park, CO by specialty
• General Practice Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.