Brooks F Bock, M.D.
Individual provider Active NPI Emergency Medical Services (Emergency Medicine) Physician · Avon, CO
NPI 1174583900 · NPPES record last updated Feb 20, 2017
Key facts
- NPI
- 1174583900
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 207PE0004X
- License
- 35927 (CO)
- Practice address
- 50 Buck Creek Road
Suite 200
Avon, CO 81620 - Phone
- (970) 926-6340
- Fax
- (970) 926-6348
- NPI assigned
- Mar 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35927 | CO | MD | Emergency Medical Services (Emergency Medicine) Physician |
| 4301029318 | MI | MD | Emergency Medical Services (Emergency Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colorado Mountain Medical, LLC | Past |
Accepting new patients | |
| Michigan Emergency Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 35927 | CO | Yes |
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 4301029318 | MI |
Addresses
Primary practice location
50 Buck Creek Road
Suite 200
Avon, CO 81620
Mailing address
PO Box 4330
Avon, CO 81620-4330
Phone (970) 926-6340
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80885039 | Medicaid | CO | |
| 101709949 | Medicaid | MI | |
| 101987786 | Medicaid | MI | |
| BB029318 | Other | MI | BC/BS OF MI |
Other providers in Avon, CO
- Michael Dennis Barry
- Charity Tamar Batson
- Rochelle S. Bernstein
- Melina Bjornson
- Gary M Blamire
- Pamela Bock
- Joan Carol Bornstein
- Jennifer L. Bouldry
- Debra Elaine Burns
- Nina E Campanile
All providers in Avon, CO · Emergency Medical Services (Emergency Medicine) 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 20, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.