Poudre Valley Medical Group, LLC
NPI 1174248793ActiveOrganization· Family Medicine· Broomfield, CO
Family Medicine in Broomfield, Colorado, registered in NPPES in October 2022, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.
Overview
| NPI | 1174248793 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Poudre Valley Medical Group, LLC |
| NPI issued | Oct 6, 2022 |
| Last updated in NPPES | Jun 11, 2024 |
| Certified by provider | Jun 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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