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 MBA, RHIA (DIRECTOR OF CREDENTIALING)
(303) 776-1234
Entity
Organization
Contact information
Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084N0400X
Neurology Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
208800000X
Urology Physician
—
—
231H00000X
Audiologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75302373
—
CO
Enumeration date
02/04/2019
Last updated
08/08/2024
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