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Poudre Valley Medical Group, LLC

Organization Active NPI Obstetrics & Gynecology Physician · Longmont, CO

NPI 1295495372 · NPPES record last updated Jul 15, 2024

Key facts

NPI
1295495372
Entity type
Organization (NPI type 2)
Primary specialty
Obstetrics & Gynecology Physician 207V00000X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Practice address
1760 E Ken Pratt Blvd Ste 201
Longmont, CO 80504-5311
Phone
(720) 718-8222
Fax
(720) 718-5986
NPI assigned
Dec 30, 2021
Organization subpart
Yes
Parent organization (as reported)
POUDRE VALLEY MEDICAL GROUP, LLC

Authorized official

Name
Jana Conroy
Title
Director of Credentialing
Phone
(720) 718-8222

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Poudre Valley Medical LLC (282 organizations share this tax ID)
Part of
Poudre Valley Medical LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X Yes

Addresses

Primary practice location

1760 E Ken Pratt Blvd Ste 201
Longmont, CO 80504-5311

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071

Other names

  • UCHealth Medical Group Doing business as
  • UCHealth Women's Care Clinic - LPMC Other name

Other providers in Longmont, CO

All providers in Longmont, CO · Obstetrics & Gynecology Physician in Colorado

Sources for this page

Verify at the official NPI Registry.