NPIMap

Poudre Valley Medical Group, LLC

Organization Active NPI Family Medicine Physician · Longmont, CO

NPI 1770048845 · NPPES record last updated Aug 24, 2026

Key facts

NPI
1770048845
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Practice address
1925 Mountain View Ave
Longmont, CO 80501-3128
Phone
(303) 776-1234
NPI assigned
Feb 4, 2019
Organization subpart
Yes
Parent organization (as reported)
POUDRE VALLEY MEDICAL GROUP, LLC

Authorized official

Name
Jana Conroy, MBA, RHIA
Title
Director of Credentialing
Phone
(303) 776-1234

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

Locations

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Gastroenterology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RG0100X
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RP1001X
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X
Otolaryngology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Y00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208000000X
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208100000X
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084N0400X
Plastic and Reconstructive Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0122X
Pain Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208VP0000X
Audiologist
Group: 193200000X MULTI-SPECIALTY GROUP		 231H00000X

Addresses

Primary practice location

1925 Mountain View Ave
Longmont, CO 80501-3128

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
75302373MedicaidCO

Other names

  • UCHealth Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 24, 2026.

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787529600000",
    "number": "1770048845",
    "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": "1925 MOUNTAIN VIEW AVE",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013128",
            "telephone_number": "303-776-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "enumeration_date": "2019-02-04",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "303-776-1234",
        "authorized_official_credential": "MBA, RHIA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75302373",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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Sources for this page

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