MEDICARE: POUDRE VALLEY MEDICAL GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1801418769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POUDRE VALLEY MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 150
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9071
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2695 ROCKY MOUNTAIN AVE STE 200
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9075
Country	:	US
Telephone Number	:	970-297-6610
Fax Number	:	970-297-6611

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	JANA CONROY
Credential	:
Telephone Number	:	970-297-6610

Provider Enumeration Date	:	05/14/2020
Last Update Date	:	02/12/2025

Similar Medicare Providers

1073483889 — JEREMY GARDNER PMHNP
Practice Location Address:

2695 ROCKY MOUNTAIN AVE STE 260
LOVELAND, CO
80538-9075

Practice Phone: 720-712-0306
Practice Fax:

1659445633 — JOHN WINSLOW CARLTON M.D.
Practice Location Address:

2695 ROCKY MOUNTAIN AVE. , SUITE 200
LOVELAND, CO
80538-9075

Practice Phone: 970-493-7442
Practice Fax: 970-493-2990

1730304593 — CHRISTY LYNN YOUNG MD
Practice Location Address:

2695 ROCKY MOUNTAIN AVE STE 200
LOVELAND, CO
80538-9075

Practice Phone: 970-667-7664
Practice Fax: 970-622-9843

1770967408 — DR. KENNETH A MORRIS M.D., PH.D.
Practice Location Address:

2695 ROCKY MOUNTAIN AVE STE 200
LOVELAND, CO
80538-9075

Practice Phone: 970-667-7664
Practice Fax: 970-622-9843

1992272108 — LAUREN THAYER FNP-BC
Practice Location Address:

2695 ROCKY MOUNTAIN AVE STE 200
LOVELAND, CO
80538-9075

Practice Phone: 970-667-7664
Practice Fax:

1811886732 — PHOENIX PHYSICAL THERAPY LLC
Practice Location Address:

2452 SILVERTON ST
LOVELAND, CO
80538-6209

Practice Phone: 770-377-4380
Practice Fax:

Directions to “POUDRE VALLEY MEDICAL GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.