George Bradley Klock, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

1998 Issued in IA

Practice address

3200 Grand Ave
Des Moines, IA 50312-4104

Phone

(515) 271-1722

Fax

(515) 271-1697

NPI assigned

Sep 7, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• G Bradley Klock Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1104810001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1722",
            "fax_number": "515-271-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124104",
            "telephone_number": "515-271-1722",
            "fax_number": "515-271-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOCK",
        "first_name": "GEORGE",
        "middle_name": "BRADLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "AZ",
            "license": "1890",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "IA",
            "license": "1998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARIZONA",
            "identifier": "AZ0064860",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104810001",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G",
            "last_name": "KLOCK",
            "middle_name": "BRADLEY",
            "credential": "DO PC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Heidi Joy Klingelhofer, DO
• Sarah Klinger, MD
• Nicholas Klinkefus
• Joseph George Klipping, LMHC
• Mark Allen Kloberdanz, ED.D., M.P.A
• Lisa Klock, DO
• Ty Kloft, DPT
• Aleksandra Sasha Kloos, DO
• Melissa Klotz, PHARMD
• Alyssa M Kluender

• Neuromusculoskeletal Medicine & OMM Physician in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.