POUDRE VALLEY MEDICAL GROUP, LLC
NPI 1710593611
General Practice in Fort Collins, CO
NPI Status: Active since September 17, 2020
Contact Information
1024 S LEMAY AVE
FORT COLLINS, CO
ZIP 80524
Phone: (970) 495-8440
Fax: (970) 495-7644
- Organization
- General Practice
- CLIA Number: 06D2116126
- CLIA Cert. Type: Blood Bank
- CLIA Exp. Date: 10-04-2026
About POUDRE VALLEY MEDICAL GROUP, LLC
This page provides the complete NPI Profile along with additional information for Poudre Valley Medical Group, Llc, a primary care provider established in Fort Collins, Colorado operating as a General Practice. The healthcare provider is registered in the NPI registry with number 1710593611 assigned on September 2020. The practitioner's primary taxonomy code is 208D00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Poudre Valley Medical Group, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1710593611
- Provider Legal Name
- POUDRE VALLEY MEDICAL GROUP, LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1024 S LEMAY AVE FORT COLLINS, CO 80524
- Location Phone
- (970) 495-8440
- Location Fax
- (970) 495-7644
- Mailing Address
- 2695 ROCKY MOUNTAIN AVE STE 150 LOVELAND, CO 80538
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 09-17-2020
- Last Update Date
- 12-08-2025
- Code Navigator
A primary care provider (PCP) like Poudre Valley Medical Group, Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
General Practice
- Taxonomy Code
- 208D00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | |
| 2 | 163WW0000X | Nursing Service Providers | Registered Nurse | |
| 3 | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 4 | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
| 5 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 6 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | |
| 7 | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| 8 | 261QE0002X | Ambulatory Health Care Facilities | Clinic/Center | |
| 9 | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | |
| 10 | 363LN0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 06D2116126
- Facility Type
- Blood Bank
- Certificate Effective Date
- October 05, 2024
- Certificate Expiration Date
- October 04, 2026
- Laboratory Director
- DR. MICHAEL J. WALTS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Poudre Valley Medical Group, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1710593611, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
FORT COLLINS, CO 80524
FORT COLLINS, CO 80524
FORT COLLINS, CO 80524
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710593611, enumerated as an "organization" on September 17, 2020.
The provider is located at 1024 S LEMAY AVE FORT COLLINS, CO 80524 and the phone number is (970) 495-8440.
General Practice with taxonomy code 208D00000X.
