Active NPI
Charles Douglas Brooks, MD
- Diagnostic Radiology Physician
- Amarillo, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 35.092843
- Practice address
- 1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110 - Phone
- (806) 355-3352
- Fax
- (806) 355-5367
- NPI assigned
- Dec 11, 2007
- Last updated
- Sep 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | M7874 | TX | |
| Diagnostic Radiology Physician | 2085R0202X | 35.092843 | OH | Primary |
| Diagnostic Radiology Physician | 2085R0202X | MD2010-0147 | NM |
Addresses
Primary practice location
1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110
Mailing address
1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2110
Phone (806) 355-3352
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35.092843 | Other | OH | 35.092843 |
| M7874 | Other | TX | TX LIC# M7874 |
| MD2010-0147 | Other | NM | NEW MEXICO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Texas Tech University Health Science Center School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
117 Camina de Vida
Santa Rosa, NM 88435-2259
Phone (575) 472-3417
117 E 19TH St
Roswell, NM 88201-5151
Phone (575) 627-7000
1901 Medi Park Dr
Suite 2050
Amarillo, TX 79106-2109
Phone (806) 355-3352
7400 Wallace Blvd
Amarillo, TX 79106-1818
Phone (806) 353-8333
Hospital & facility affiliations
- Bsa Hospital
- Lovelace Regional Hospital - Roswell
- Glen Rose Medical Center
- Childress Regional Medical Center
- Cogdell Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35.092843 | OH | MD | Diagnostic Radiology Physician |
| M7874 | TX | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Plains Radiological Association LLP | Diagnostic Radiology | Current | Accepting new patients |
| Open Air Imaging Center, LLP | Current | Accepting new patients | |
| Osu Radiology LLC | Diagnostic Radiology | Past | Accepting new patients |
Locations
117 Camino de Vida
Santa Rosa, NM 88435
Phone (575) 472-3417
1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000
1901 Medi Park Dr
Ste 2050
Amarillo, TX 79106
Phone (806) 355-3352
7400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-8480
Interoperability endpoints
- cbrooks21088@ahs.direct-ci.com
Organizations & group practices 3
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.
-
- Radiology Clinic/Center
- Amarillo, TX
- NPI 1609982131
-
- Diagnostic Radiology Physician
- Amarillo, TX
- NPI 1205897360
NM
-
- Diagnostic Radiology Physician
- Columbus, OH
- NPI 1912956814
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Amarillo, TX
- NPI 1407191984
-
dba Childress Regional Medical Center
- General Acute Care Hospital
- Childress, TX
- NPI 1326079534
-
dba Childress Regional Medical Center
- Clinic/Center
- Memphis, TX
- NPI 1477078517
Hospital
-
dba Childress Regional Medical Center
- Clinic/Center
- Paducah, TX
- NPI 1619493954
Hospital
-
dba Cogdell Memorial Hospital
- Critical Access Hospital
- Snyder, TX
- NPI 1578588463
-
dba Glen Rose Medical Center
- Rural Acute Care Hospital
- Glen Rose, TX
- NPI 1700826575
-
dba Lovelace Regional Hospital-Roswell
- General Acute Care Hospital
- Roswell, NM
- NPI 1972878361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285632000000",
"number": "1427231638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR",
"address_2": "SUITE 2050",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062110",
"telephone_number": "806-355-3352",
"fax_number": "806-355-5367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 MEDI PARK DR",
"address_2": "SUITE 2050",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791062110",
"telephone_number": "806-355-3352",
"fax_number": "806-355-5367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOKS",
"first_name": "CHARLES",
"middle_name": "DOUGLAS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-11",
"last_updated": "2010-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TX",
"license": "M7874",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OH",
"license": "35.092843",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "NM",
"license": "MD2010-0147",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "35.092843",
"identifier": "35.092843",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX LIC# M7874",
"identifier": "M7874",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO",
"identifier": "MD2010-0147",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Amarillo, TX
- Brock W Lovett
- Joseph Craig Brock, L.A.T.
- Peyton Nicole Bronson, APRN, FNP-C
- Andrew F Brooker Jr., M.D. PA
- Louise Marie Brooker, PA-C
- Hanna Brooks, LPC
- Patricia Ann Brooks, LMFT
- Brookstan Pharmacy LLC (Medical Square Pharmacy)
- Brookstan Pharmacy LLC (Medical Square Pharmacy)
- Broome Professionals PA (Broome Optical)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.