Active NPI
Brodie Gerrard-Gough, MD
- Surgery Physician
- Colorado Springs, CO
National Provider Identifier
1699741348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 23946
- Practice address
- 2 S Cascade Ave
140
Colorado Springs, CO 80903-1624 - Phone
- (719) 538-2936
- NPI assigned
- Feb 23, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 23946 | CO | Primary |
Addresses
Primary practice location
2 S Cascade Ave
140
Colorado Springs, CO 80903-1624
Mailing address
1633 Medical Center PT
233
Colorado Springs, CO 80907-8732
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01239466 | Medicaid | CO |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23946 | CO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Gastroenterology Associates | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Gastroenterology Physician
- Colorado Springs, CO
- NPI 1023112117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1699741348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1633 MEDICAL CENTER PT",
"address_2": "233",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809078732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 S CASCADE AVE",
"address_2": "140",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809031624",
"telephone_number": "719-538-2936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERRARD-GOUGH",
"first_name": "BRODIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-23",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CO",
"license": "23946",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01239466",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.