Individual provider Active NPI

Denise E. Stuntzner, LCSW

  • Clinical Social Worker
  • Coos Bay, OR
National Provider Identifier
1245271246
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L3811 Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2045
Phone
(541) 267-5151
NPI assigned
Jun 9, 2006
Last updated
Nov 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L3811 OR Primary

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2045

Mailing address

125 Central Ave
Ste 290
Coos Bay, OR 97420-2342
Phone (541) 267-5151

Other identifiers 4

IdentifierTypeStateIssuer
1407812365OtherORNORTH BEND MEDICAL CENTER GROUP NPI
161133OtherORNORTH BEND MEDICAL CENTER GROUP MEDICAID
93-0635514OtherORNORTH BEND MEDICAL CENTER GROUP TAX ID
R0000WFBTVOtherORNORTH BEND MEDICAL CENTER GROUP MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060901000163 OR Practitioner - Clinical Social Worker 1052314523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Center, LLC.Group PAC ID 8426046707, 5 clinicians

Practice addresses (Care Compare)

1834 McPherson St
North Bend, OR 97459-3414
Phone (541) 267-2113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Center, LLC. CurrentSince Nov 1, 2019 Accepting new patients
Palliative Care Services, Inc. Clinical Past Accepting new patients

Locations

125 Central Ave
Ste 290
Coos Bay, OR 97420
Phone (541) 267-2113

1834 McPherson St
North Bend, OR 97459
Phone (541) 267-2113

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1245271246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CENTRAL AVE",
            "address_2": "STE 290",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202342",
            "telephone_number": "541-267-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202045",
            "telephone_number": "541-267-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUNTZNER",
        "first_name": "DENISE",
        "middle_name": "E.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP NPI",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICAID",
            "identifier": "161133",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP TAX ID",
            "identifier": "93-0635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BEND MEDICAL CENTER GROUP MEDICARE",
            "identifier": "R0000WFBTV",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.