Individual provider Active NPI

John Bunkall, MD

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Goose Creek, SC
National Provider Identifier
1164017901
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
License
0101275831 Issued in VA
Practice address
Naval Health Clinic Charleston, 110 Nnptc Cir
Goose Creek, SC 29445
Phone
(626) 429-3402
NPI assigned
Mar 3, 2021
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X 0101275831 VA Primary
Military Health Care Provider 171000000X 0101275831 VA

Addresses

Primary practice location

Naval Health Clinic Charleston, 110 Nnptc Cir
Goose Creek, SC 29445

Mailing address

Naval Medical Center San Diego 38400 Bob Wilson Dr
San Diego, CA 92134-5000
Phone (626) 429-3402

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101275831VAMDMilitary Health Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1164017901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921345000",
            "telephone_number": "626-429-3402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HEALTH CLINIC CHARLESTON, 110 NNPTC CIR",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "29445",
            "telephone_number": "626-429-3402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNKALL",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "VA",
            "license": "0101275831",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101275831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.