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Poudre Valley Medical Group, LLC

NPI 1275134900ActiveOrganization· Surgery, Plastic and Reconstructive Surgery· Fort Collins, CO

Surgery, Plastic and Reconstructive Surgery in Fort Collins, Colorado, registered in NPPES in November 2020, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.

Overview

NPI1275134900
StatusActive
Entity typeOrganization (subpart)
Parent organizationPoudre Valley Medical Group, LLC
NPI issuedNov 9, 2020
Last updated in NPPESJul 15, 2024
Certified by providerJul 15, 2024

Specialties and licenses

TaxonomyCodeLicenseState
Surgery, Plastic and Reconstructive Surgery Primary2086S0122X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

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