POUDRE VALLEY MEDICAL GROUP LLC, General Practice FORT COLLINS, CO

Contact Information

POUDRE VALLEY MEDICAL GROUP, LLC

1024 S LEMAY AVE
FORT COLLINS, CO 80524-3929

Phone: 970-495-8440
Fax: 970-495-7644
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
General Practice	208D00000X	99	Physician/Undefined Physician type[6]
Clinic/Center	261Q00000X
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Emergency Care	261QE0002X
Hospice and Palliative Medicine	207RH0002X	11	Physician/Internal Medicine
Hospitalist	208M00000X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Neonatal	363LN0000X	50	Nurse Practitioner
Physical Medicine & Rehabilitation	208100000X	25	Physician/Physical Medicine and Rehabilitation
Psychiatry	2084P0800X	26	Physician/Psychiatry
Wound Care	163WW0000X

Indicates primary specialty

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NPI Profile & details for POUDRE VALLEY MEDICAL GROUP LLC · (Female)

NPI Number	`1710593611`
Status	Active
Credentials
Entity	Individual
Enumeration date	09/17/2020
Last updated	12/08/2025 - About 6 months ago
Sole proprietor ¹	Not specified
Identifiers	Not Available
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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