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POUDRE VALLEY INTERNISTS PC NPI 1417993916


NPI Information

NPI: 1417993916
Provider Name: POUDRE VALLEY INTERNISTS PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
4674 SNOW MESA DR
STE 100
FORT COLLINS, CO
ZIP 80528
Phone: (970) 482-3712
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POUDRE VALLEY INTERNISTS PC is a specialist in Fort Collins, CO. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. POUDRE VALLEY INTERNISTS PC NPI is 1417993916. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4674 SNOW MESA DR
STE 100
FORT COLLINS, CO
ZIP 80528-615
Phone: (970) 482-3712
Fax: (970) 482-4057

The provider's authorized official is Melissa Mccann-stoeckle .
The authorized official title is Billing Manager and has the following contact phone number (970) 482-3712.

The enumeration date for this NPI number is 6/22/2006 and was last updated on 5/1/2009.


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
1174400000XSpecialistYes

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
1A8908MEDICARE ID-TYPE UNSPECIFIEDCOLORADO
206D0911568OTHERCOLORADOCLIA
3117631500MEDICAIDWYOMING
410025031400MEDICAIDNEBRASKA
5CH9273MEDICARE ID-TYPE UNSPECIFIEDCOLORADORAILROAD
605675839MEDICAIDCOLORADO

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

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