NPIMap

Organization Active NPI

Poudre Valley Medical Group

Doing business as UCHealth Medical Group

  • Family Medicine Physician
  • Denver, CO
National Provider Identifier
1659031748
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
POUDRE VALLEY MEDICAL GROUP
Doing business as
UCHealth Medical Group
Practice address
4660 Yosemite St
Suite 100
Denver, CO 80238-4481
Phone
(720) 516-8902
NPI assigned
Dec 30, 2021
Last updated
Aug 5, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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
(720) 516-8902

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Family Medicine Physician 207Q00000X Primary
Occupational Medicine Physician 2083X0100X

Addresses

Primary practice location

4660 Yosemite St
Suite 100
Denver, CO 80238-4481

Mailing address

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

Other names 1

  • UCHealth Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Poudre Valley Medical Group283 organizations share this tax ID, including this one
Part of
Poudre Valley Medical Group

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1659031748",
    "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": "4660 YOSEMITE ST",
            "address_2": "SUITE 100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802384481",
            "telephone_number": "720-516-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "enumeration_date": "2021-12-30",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "720-516-8902"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "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"
        }
    ]
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.