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POUDRE VALLEY MEDICAL GROUP LLC NPI 1497415582


NPI Information

NPI: 1497415582
Provider Name: POUDRE VALLEY MEDICAL GROUP, LLC

Other Name: UCHEALTH MEDICAL GROUP

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 06D2254503

Address:
1760 E KEN PRATT BLVD STE 405
LONGMONT, CO
ZIP 80504
Phone: (720) 718-5420
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POUDRE VALLEY MEDICAL GROUP, LLC is a cardiovascular disease internal medicine in Longmont, CO. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. POUDRE VALLEY MEDICAL GROUP, LLC NPI is 1497415582. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Uchealth Medical Group.

The provider's business location address is:

1760 E KEN PRATT BLVD STE 405
LONGMONT, CO
ZIP 80504-311
Phone: (720) 718-5420
Fax: (720) 718-5991

The provider's authorized official is Jana Conroy .
The authorized official title is Director Of Credentialing and has the following contact phone number (720) 718-5420.

The CLIA number assigned to this NPI record is 06D2254503 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2021 and was last updated on 10/12/2023.


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
1207RP1001XInternal MedicinePulmonary DiseaseNo
2261QR0404XClinic/CenterRehabilitation, Cardiac FacilitiesNo
3207RC0000XInternal MedicineCardiovascular DiseaseYes

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.