NPIMap

Poudre Valley Medical Group, LLC

Organization Active NPI Pain Medicine Physician · Pueblo, CO

NPI 1316733751 · NPPES record last updated Apr 15, 2025

Key facts

NPI
1316733751
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine Physician 208VP0000X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Practice address
1600 N Grand Ave Ste 520
Pueblo, CO 81003-2757
Phone
(719) 562-2360
Fax
(719) 562-2399
NPI assigned
Apr 15, 2025
Organization subpart
Yes
Parent organization (as reported)
POUDRE VALLEY MEDICAL GROUP, LLC

Authorized official

Name
Jana Conroy
Title
Director of Credentialing
Phone
(719) 562-2360

Corporate family (same tax ID) 24

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2145979Uchealth Pain Management Clinic - Parkview Mob
1600 N Grand Ave, Suite 520, Pueblo, CO 81003		Certificate of waiverMar 19, 2028

National Provider Directory

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

Locations

1600 N Grand Ave
Ste 520
Pueblo, CO 81003
Phone (719) 542-3100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208VP0000X Yes

Addresses

Primary practice location

1600 N Grand Ave Ste 520
Pueblo, CO 81003-2757

Mailing address

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

Other names

  • UCHealth Medical Group Doing business as
  • UCHealth Pain Management Clinic - Parkview MOB Other name

Other providers in Pueblo, CO

All providers in Pueblo, CO · Pain Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.