Poudre Valley Medical Group, LLC
NPI 1104439322ActiveOrganization· Radiology, Radiation Oncology· Colorado Springs, CO
Radiology, Radiation Oncology in Colorado Springs, Colorado, registered in NPPES in August 2020, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.
Overview
| NPI | 1104439322 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Poudre Valley Medical Group, LLC |
| NPI issued | Aug 27, 2020 |
| Last updated in NPPES | May 22, 2024 |
| Certified by provider | May 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Radiology, Radiation Oncology Primary | 2085R0001X | — | — |
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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