Poudre Valley Medical Group, LLC
NPI 1063209534ActiveOrganization· Psychiatry & Neurology, Psychiatry· Pueblo, CO
Psychiatry & Neurology, Psychiatry in Pueblo, Colorado, registered in NPPES in April 2025, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.
Overview
| NPI | 1063209534 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Poudre Valley Medical Group, LLC |
| NPI issued | Apr 21, 2025 |
| Last updated in NPPES | Apr 21, 2025 |
| Certified by provider | Apr 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Psychiatry Primary | 2084P0800X | — | — |
| Counselor, Professional | 101YP2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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