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Poudre Valley Medical Group, LLC

Organization Active NPI Family Medicine Physician · Colorado Springs, CO

NPI 1568075893 · NPPES record last updated Aug 1, 2024

Key facts

NPI
1568075893
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Practice address
320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535
Phone
(719) 365-7420
Fax
(719) 365-7421
NPI assigned
Aug 26, 2020
Organization subpart
Yes
Parent organization (as reported)
POUDRE VALLEY MEDICAL GROUP, LLC

Authorized official

Name
Jana Conroy
Title
Director of Credentialing
Phone
(719) 365-7420

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
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes

Addresses

Primary practice location

320 E Fontanero St Ste 100
Colorado Springs, CO 80907-7535

Mailing address

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

Other names

  • UCHealth Medical Group Doing business as
  • UCHealth Primary Care - Fontanero Other name

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Family Medicine Physician in Colorado

Sources for this page

Verify at the official NPI Registry.