Individual provider Active NPI

Elizabeth Perry Gundersen, M.D.

  • Pediatrics Physician
  • Helena, MT
National Provider Identifier
1205178100
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4285 Issued in MT
Practice address
530 Rodney CT
Helena, MT 59601-6332
Phone
(406) 443-1279
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4285 MT Primary

Addresses

Primary practice location

530 Rodney CT
Helena, MT 59601-6332

Mailing address

530 Rodney CT
Helena, MT 59601-6332
Phone (406) 443-1279

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
4285MTMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1205178100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RODNEY CT",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596016332",
            "telephone_number": "406-443-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 RODNEY CT",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596016332",
            "telephone_number": "406-443-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "ELIZABETH",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "4285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; 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.