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POUDRE VALLEY MEDICAL GROUP LLC NPI 1770048845


NPI Information

NPI: 1770048845
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC

Doing Business As: UCHEALTH MEDICAL GROUP

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 06D1028422

Address:
1925 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501
Phone: (303) 776-1234
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POUDRE VALLEY MEDICAL GROUP, LLC is an internal medicine in Longmont, CO. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1770048845. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Uchealth Medical Group.

The provider's business location address is:

1925 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501-128
Phone: (303) 776-1234

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (303) 776-1234.

The CLIA number assigned to this NPI record is 06D1028422 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/4/2019 and was last updated on 3/5/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineYes
3207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
4207RG0100XInternal MedicineGastroenterologyNo
5207RP1001XInternal MedicinePulmonary DiseaseNo
6207RR0500XInternal MedicineRheumatologyNo
7207T00000XNeurological SurgeryNo
8207V00000XObstetrics & GynecologyNo
9207Y00000XOtolaryngologyNo
10208000000XPediatricsNo
11208100000XPhysical Medicine & RehabilitationNo
122084N0400XPsychiatry & NeurologyNeurologyNo
132086S0122XSurgeryPlastic and Reconstructive SurgeryNo
14208800000XUrologyNo
15231H00000XAudiologistNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
175302373MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.