NPIMap

Organization Active NPI

Poudre Valley Health Care, Inc

  • Medical Specialty Clinic/Center
  • Fort Collins, CO
National Provider Identifier
1144535444
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
POUDRE VALLEY HEALTH CARE, INC
Practice address
1025 Pennock PL Ste 121
Fort Collins, CO 80524-3250
Phone
(970) 495-8980
NPI assigned
Aug 11, 2010
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
POUDRE VALLEY HEALTH CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
David Thompson
Title
Cfo
Phone
(970) 495-7000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Ambulatory Family Planning Facility 261QA0005X NU
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

1025 Pennock PL Ste 121
Fort Collins, CO 80524-3250

Mailing address

7901 E Lowry Blvd
Mail Stop F402
Denver, CO 80230-6507

Other identifiers 1

IdentifierTypeStateIssuer
40486061MedicaidCO

Other names 1

  • Poudre Valley Hospital Family Medicine Center Walk In Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000791 CO Part B Supplier - Clinic/Group Practice 7618880709 Receives reassigned benefits from 160 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Collins, CO

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Fort Collins Family Med

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1144535444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 E LOWRY BLVD",
            "address_2": "MAIL STOP F402",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802306507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 PENNOCK PL STE 121",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243250",
            "telephone_number": "970-495-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY HEALTH CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY HEALTH CARE INC",
        "enumeration_date": "2010-08-11",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-495-7000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40486061",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poudre Valley Hospital Family Medicine Center Walk In Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.