POUDRE VALLEY MEDICAL GROUP, LLC; NPI #1710593611

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

NPI #	`1710593611`
LBN Legal business name	POUDRE VALLEY MEDICAL GROUP, LLC
Authorized official	JANA CONROY - (DIRECTOR OF CREDENTIALING)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	09/17/2020
Last updated	12/08/2025 - About 6 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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POUDRE VALLEY MEDICAL GROUP, LLC

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NPI Profile & details for POUDRE VALLEY MEDICAL GROUP, LLC

Reviews for POUDRE VALLEY MEDICAL GROUP, LLC