Poudre Valley Medical Group, LLC
NPI 1629876214ActiveOrganization· Internal Medicine, Gastroenterology· Pueblo, CO
Internal Medicine, Gastroenterology in Pueblo, Colorado, registered in NPPES in March 2025, part of Poudre Valley Medical Group, LLC. The authorized official on file is Jana Conroy, Director Of Credentialing.
Overview
| NPI | 1629876214 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Poudre Valley Medical Group, LLC |
| NPI issued | Mar 7, 2025 |
| Last updated in NPPES | Mar 7, 2025 |
| Certified by provider | Mar 7, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Gastroenterology Primary | 207RG0100X | — | — |
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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