# POUDRE VALLEY MEDICAL GROUP, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Other names:** UCHealth Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245859842
- **Legal business name:** POUDRE VALLEY MEDICAL GROUP, LLC
- **Authorized official:** JANA CONROY (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (720) 652-7055

## Contact information

- **Practice address:** 5965 FIRESTONE BLVD BLDG B, FIRESTONE, CO 80504-6607
- **Practice address phone:** (720) 652-7055
- **Practice address fax:** (720) 652-7056
- **Mailing address:** 2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |
| 261QU0200X | Urgent Care Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 04/14/2020
- **Last updated:** 07/12/2024