John R Bumgarner, M.D.
Individual provider Active NPI Vascular & Interventional Radiology Physician · Grand Junction, CO
NPI 1104808633 · NPPES record last updated Feb 16, 2010
Key facts
- NPI
- 1104808633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular & Interventional Radiology Physician 2085R0204X
- License
- 33374 (CO)
- Practice address
- 2635 N 7TH St
Grand Junction, CO 81501-8209 - Phone
- (970) 241-9729
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Interventional Radiology
- Education
- Duke University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain Radiology Inc
Practice addresses (Care Compare)
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 900-6856
Hospital & facility affiliations
- Intermountain Health St. Mary'S Regional Hospital
- Memorial Hospital, the
- Community Hospital
- Family Health West Hospital
- Delta County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100407000486 | CO | Practitioner - Interventional Radiology | 0042109332 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33374 | CO | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Colorado Radiologic Associates, PC | Current |
Accepting new patients | |
| Mountain Radiology, Inc | Vascular & Interventional Radiology | Current |
Accepting new patients |
Locations
600 Russell St
Craig, CO 81625
Phone (970) 824-3252
1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033
750 Wellington Ave
Grand Junction, CO 81501
Phone (970) 244-2457
2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009
2530 N 8th St
Ste 101
Grand Junction, CO 81501
Phone (970) 241-4937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician | 2085R0204X | 33374 | CO | Yes |
Addresses
Primary practice location
2635 N 7TH St
Grand Junction, CO 81501-8209
Mailing address
2530 N 8TH St
101
Grand Junction, CO 81501-8856
Phone (970) 241-9729
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01333749 | Medicaid | CO |
Other providers in Grand Junction, CO
- Megan Bull
- Anthony B Bullard
- Heather Bullis
- Carri Bullock
- Evan R. Bumgarner
- Angela Bunnell
- Nancy Elizabeth Burford
- Maddison Rayanne Burge
- Jack B Burger
- Chloe Burke
All providers in Grand Junction, CO · Vascular & Interventional Radiology Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.