NPIMap

Organization Active NPI

Poudre Valley Medical Group, LLC

Doing business as UCHealth Medical Group

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1841821089
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Doing business as
UCHealth Medical Group
Practice address
8540 Scarborough Dr Ste 100
Colorado Springs, CO 80920-7518
Phone
(719) 364-6970
Fax
(719) 365-7667
NPI assigned
Jan 27, 2020
Last updated
Aug 19, 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 19, 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
(719) 364-6970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

8540 Scarborough Dr Ste 100
Colorado Springs, CO 80920-7518

Mailing address

2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (719) 364-6970

Other names 2

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D1070362Uchealth Primary Care - Scarborough8540 Scarborough Dr, Suite 100, Colorado Springs, CO 80920Certificate of waiverJun 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Poudre Valley Med GRP LLC283 organizations share this tax ID, including this one
Part of
Poudre Valley Med GRP LLC

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": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1841821089",
    "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",
            "telephone_number": "719-364-6970",
            "fax_number": "719-365-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 SCARBOROUGH DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207518",
            "telephone_number": "719-364-6970",
            "fax_number": "719-365-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POUDRE VALLEY MEDICAL GROUP, LLC",
        "enumeration_date": "2020-01-27",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "CONROY",
        "authorized_official_first_name": "JANA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "719-364-6970"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCHealth Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UCHealth Primary Care - Scarborough",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.