Karen Marie Gunderson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001001421 Issued in NC

Practice address

557 Brookdale Dr
Statesville, NC 28677-4107

Phone

(980) 259-2498

NPI assigned

Jul 10, 2008

Last updated

Aug 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Optimed Hospitalists

  • Hospitalist Physician
  • Statesville, NC
  • NPI 1235449125
  Medicare reassignment
• Optimed Hospitalists

  dba OptiMed Specialty Services

  • Internal Medicine Physician
  • Davidson, NC
  • NPI 1477942613
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Pulmonary Medicine

  • Pulmonary Disease Physician
  • Marietta, GA
  • NPI 1639475270
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1205090115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 DELBURG ST",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368655",
            "telephone_number": "980-259-2498",
            "fax_number": "980-231-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 BROOKDALE DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774107",
            "telephone_number": "980-259-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001001421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1205090115",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Sterling Griffith
• Joel Kenneth Grimberg, PHARMD, RPH
• Ruby Ann Grimm, M.D.
• Constance Ellen Grundmeyer, R.N.
• Linda L Guentner, RN
• Courtney Lynn Haddock, FNP-C
• Meredith Haley
• Christopher Hall, MD
• Travis Scott Hall, RPH
• Andrew Hallett

• Physician Assistant in Statesville, NC
• Providers in Statesville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.