Individual provider Active NPI

Douglas Brent Rock, M.D.

  • Radiation Oncology Physician
  • Grand Junction, CO
National Provider Identifier
1275531725
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
36547 Issued in CO
Practice address
750 Wellington Ave
St. Mary's Medical Pavilion, Radiation Oncology
Grand Junction, CO 81501-6132
Phone
(970) 244-2442
Fax
(970) 244-7008
NPI assigned
Jul 8, 2005
Last updated
Jul 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 36547 CO Primary

Addresses

Primary practice location

750 Wellington Ave
St. Mary's Medical Pavilion, Radiation Oncology
Grand Junction, CO 81501-6132

Mailing address

751 Horizon CT
Suite 259
Grand Junction, CO 81506-8733
Phone (970) 257-1786

Other identifiers 2

IdentifierTypeStateIssuer
1365477MedicaidCO
841340905003OtherCOROCKY MOUNTAIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36547COMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince May 20, 2014 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince May 20, 2014 Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

750 Wellington Ave
Grand Junction, CO 81501
Phone (970) 298-7500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1275531725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 HORIZON CT",
            "address_2": "SUITE 259",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068733",
            "telephone_number": "970-257-1786",
            "fax_number": "970-257-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE",
            "address_2": "ST. MARY'S MEDICAL PAVILION,  RADIATION ONCOLOGY",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-244-2442",
            "fax_number": "970-244-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "DOUGLAS",
        "middle_name": "BRENT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "36547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1365477",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN",
            "identifier": "841340905003",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.