Poudre Valley Medical Group, LLC
Organization Active NPI Urology Physician · Walsenburg, CO
NPI 1699562181 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1699562181
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- POUDRE VALLEY MEDICAL GROUP, LLC
- Practice address
- 23500 US Highway 160
Walsenburg, CO 81089-9524 - Phone
- (719) 738-4588
- Fax
- (719) 738-4534
- NPI assigned
- Apr 21, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
- Name
- Jana Conroy
- Title
- Director of Credentialing
- Phone
- (719) 738-4588
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Poudre Valley Medical LLC
- Part of
- Poudre Valley Medical LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
23500 US Highway 160
Walsenburg, CO 81089-9524
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Other names
- UCHealth Medical Group
- UCHealth Urology Clinic - Walsenburg
Other providers in Walsenburg, CO
- Mountain Creek Home Health, Inc.
- Normajean Mower
- C David Neece
- Phil Warlick, DDS, Inc
- Poudre Valley Medical Group, LLC
- Pueblo Community Health Center Inc
- Pueblo Community Health Center Inc
- Pueblo Radiological Group, P.C.
- Qualicenters Pueblo, LLC
- Rocky Mountain Clinics LLC
All providers in Walsenburg, CO · Urology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.