Active NPI
Donn Andrew Rouge, MD
- Anatomic Pathology & Clinical Pathology Physician
- Pueblo, CO
National Provider Identifier
1912961376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 20823
- Practice address
- 1008 Minnequa
Pueblo, CO 81004 - Phone
- (719) 560-4000
- NPI assigned
- Apr 13, 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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 20823 | CO | Primary |
Addresses
Primary practice location
1008 Minnequa
Pueblo, CO 81004
Mailing address
PO Box 744127
Dallas, TX 75374
Phone (719) 560-5030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01208230 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1912961376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744127",
"city": "DALLAS",
"state": "TX",
"postal_code": "75374",
"telephone_number": "719-560-5030",
"fax_number": "719-506-5059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1008 MINNEQUA",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81004",
"telephone_number": "719-560-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUGE",
"first_name": "DONN",
"middle_name": "ANDREW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-13",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CO",
"license": "20823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01208230",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.