DR. JACK RYAN BAGLEY (NPI# 1225355670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225355670 |
| Entity Type | Individual |
| Full Name | DR. JACK RYAN BAGLEY |
| Credential | M.D. |
| Practice Address |
2596 F Rd Grand Junction CO 81505-1443 |
| Mailing Address |
Po Box 1687 Grand Junction CO 81502-1687 |
| Practice Telephone | 9702543180 |
| Mailing Telephone | 9702566322 |
| Mailing Fax Number | 9702632691 |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2015-11-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
DR.0055700 | CO | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083653745 | Jack Llorrac Bagley | Physician Assistant | 2208 S 17th St, Wilmington, NC 28401-7593 | 2006-06-06 |
| Street Address |
2596 F RD |
| City | GRAND JUNCTION |
| State | CO |
| Zip Code | 81505-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033117643 | Gayle Patrice Miller | Radiology | 2596 F Rd, Grand Junction, CO 81505-1443 | 2005-07-08 |
| 1861039604 | Colorado West Healthcaresystem, Inc | Family Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2019-11-27 |
| 1487130670 | Courtney Fulton | Surgery | 2596 F Rd, Grand Junction, CO 81505-1443 | 2018-07-11 |
| 1164918488 | Stephanie Lee Evangelisti | Pharmacist | 2596 F Rd, Grand Junction, CO 81505-1443 | 2018-07-10 |
| 1811398324 | Colorado West Healthcare System | Internal Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2014-09-16 |
| 1447690938 | Kristina Goutsouliak | Internal Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2013-06-27 |
| 1356506265 | Jonathan D King | Internal Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2008-07-21 |
| 1841454048 | Sudy Elizabeth Jahangiri | Internal Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2008-07-16 |
| 1538209606 | Heather Ashley Steele | Internal Medicine | 2596 F Rd, Grand Junction, CO 81505-1443 | 2007-02-07 |
| 1457457020 | Ruth Higdon | Obstetrics & Gynecology | 2596 F Rd, Grand Junction, CO 81505-1443 | 2006-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255954061 | The Center At Foresight, LLC | Skilled Nursing Facility | 2594 Patterson Road, Grand Junction, CO 81505 | 2020-05-27 |
| 1457864845 | Haley Shae Oberst | Physician Assistant | 604 25 Rd, Grand Junction, CO 81505 | 2017-11-08 |
| 1780107896 | Robert Rogers | Registered Nurse | 2351 G Rd., Community Hospital, Grand Junction, CO 81505 | 2017-07-20 |
| 1952834871 | Carol Joy Graham | Counselor | 585 25 1/2 Rd. Sp 175, Grand Junction, CO 81505 | 2017-04-07 |
| 1356894059 | Amel Med, LLC | Anesthesiology | 2460 Patterson Rd #4, Grand Junction, CO 81505 | 2016-07-28 |
| 1528479649 | Adam Neff | Specialist/Technologist | 2188 I Road, Grand Junction, CO 81505 | 2014-05-12 |
| 1689003766 | Canyon View Asc, LLC | Clinic/Center | 2373 G Road, Suite 180, Grand Junction, CO 81505 | 2013-11-08 |
| 1700220993 | Grand Mesa Spine and Sport LLC | Pain Medicine | 201 West Park Dr, Grand Junction, CO 81505 | 2013-04-18 |
| 1295026409 | Nuclear Care Partners, LLC | Case Management | 631 24 1/2 Road, Suite C, Grand Junction, CO 81505 | 2011-04-21 |
| 1265734883 | Dillon Companies LLC | Durable Medical Equipment & Medical Supplies | 630 24 Rd, Grand Junction, CO 81505 | 2010-12-02 |
| Find all providers in zip 81505 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033117643 | Gayle Patrice Miller | Radiology | 2596 F Rd, Grand Junction, CO 81505-1443 | 2005-07-08 |
| 1275531725 | Douglas Brent Rock | Radiology | 750 Wellington Ave, St. Mary's Medical Pavilion, Radiation Oncology, Grand Junction, CO 81501-6132 | 2005-07-08 |
| 1891109559 | Lucas Gilbride | Radiology | 750 Wellington Ave, Grand Junction, CO 81501-6132 | 2014-06-19 |
| 1649278003 | Vernon James King | Radiology | 750 Wellington Ave, St. Mary's Medical Pavilion, Radiation Oncology, Grand Junction, CO 81501-6132 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1104439322 | Poudre Valley Medical Group, LLC | Radiology | 525 Bob Peters Grv Ste 100, Colorado Springs, CO 80909-4533 | 2020-08-27 |
| 1093005738 | Timothy Victor Waxweiler | Radiology | 525 Bob Peters Grv, Radiation Oncology, Colorado Springs, CO 80950-0001 | 2011-04-14 |
| 1609020312 | Sana Dole Karam | Radiology | 1665 Aurora Ct Ste 1032, Aurora, CO 80045-2517 | 2008-11-07 |
| 1598912735 | Jeffrey R Olsen | Radiology | 535 Peters Grove Suite 100, Colorado Springs, CO 80909-4533 | 2008-08-19 |
| 1265697890 | Carole Lepper Milligan | Radiology | 1320 Blue Spruce Ct, Steamboat Springs, CO 80487-3027 | 2008-07-23 |
| 1528233905 | Valley Radiotherapy Associates Medical Group Inc | Radiology | 799 E. Hampden Avenue, Englewood, CO 80113-2700 | 2008-04-25 |
| 1285834945 | Eugene Chung | Radiology | 4700 Hale Pkwy Ste 150, Denver, CO 80220-4054 | 2007-07-20 |
| 1497887624 | Seth D Reiner | Radiology | 2555 S. Downing St, Denver, CO 80210 | 2007-03-12 |
| 1689763369 | The Prostate Seed Center, LLC | Radiology | 3440 Youngfield St Pmb 115, Wheat Ridge, CO 80033-5245 | 2006-10-12 |
| Find all providers with the same taxonomy | ||||
| City | GRAND JUNCTION |
| Zip Code | 81505 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.