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Organization

POUDRE VALLEY MEDICAL GROUP, LLC

Active
Parent organization
POUDRE VALLEY MEDICAL GROUP, LLC
Other names
UCHealth Medical Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official
JANA CONROY (DIRECTOR OF CREDENTIALING)
(720) 718-3930
Entity
Organization

Contact information

Practice address
1760 E KEN PRATT BLVD STE 205, LONGMONT, CO 80504-5311
(720) 718-3930
(720) 718-0939
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RP1001X
Pulmonary Disease Physician
208600000X
Surgery Physician

Other

Enumeration date
12/30/2021
Last updated
09/02/2025
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