NPIMap

Individual provider Active NPI

Rachael Gollub, MD

  • Family Medicine Physician
  • Grand Junction, CO
National Provider Identifier
1295393767
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
TL0007519 Issued in CO
Practice address
2698 Patterson Road
Grand Junction, CO 81506
Phone
(970) 298-2800
NPI assigned
May 30, 2019
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X TL0007519 CO Primary

Addresses

Primary practice location

2698 Patterson Road
Grand Junction, CO 81506

Mailing address

2698 Patterson Road
Grand Junction, CO 81506
Phone (970) 298-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926000992 CO Practitioner - Family Practice 3375878119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Northeastern Ohio University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2635 N 7TH St
Suite 4205 Grand Junction Hospitalists
Grand Junction, CO 81501-8209
Phone (970) 298-7783

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Family Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 19, 2022 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 19, 2022 Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients
St. Mary's Hospital and Medical Center, Inc. Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

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
Ste 4205
Grand Junction, CO 81501
Phone (970) 298-7049

2698 Patterson Rd
Grand Junction, CO 81506
Phone (970) 298-2800

Interoperability endpoints

  • Direct secure messaging: rachael.gollub.1@17164.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1295393767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON ROAD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81506",
            "telephone_number": "970-298-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2698 PATTERSON ROAD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "81506",
            "telephone_number": "970-298-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLLUB",
        "first_name": "RACHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "TL0007519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.