NPIMap

Organization Active NPI

James M Yun MD PC

Doing business as ENT Associates of Roseburg LLC

  • Otolaryngology Physician
  • Roseburg, OR
National Provider Identifier
1255667747
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD26302 Issued in OR
Legal business name
JAMES M YUN MD PC
Doing business as
ENT Associates of Roseburg LLC
Practice address
2423 NW Troost St
Roseburg, OR 97471-1706
Phone
(541) 677-3400
Fax
(541) 677-3405
NPI assigned
Oct 19, 2009
Last updated
Jul 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Dr. James Michael Yun, MDNPI 1144273566
Title
Physician
Phone
(541) 677-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD26302 OR Primary

Addresses

Primary practice location

2423 NW Troost St
Roseburg, OR 97471-1706

Mailing address

2423 NW Troost St
Roseburg, OR 97471-1706
Phone (541) 677-3400

Other identifiers 1

IdentifierTypeStateIssuer
500614895MedicaidOR

Other names 1

  • ENT Associates of Roseburg LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100107000633 OR Part B Supplier - Clinic/Group Practice 0244371672 Receives reassigned benefits from 6 practitioners
Practice locations: Roseburg, OR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1255667747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 NW TROOST ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711706",
            "telephone_number": "541-677-3400",
            "fax_number": "541-677-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 NW TROOST ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711706",
            "telephone_number": "541-677-3400",
            "fax_number": "541-677-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES M YUN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "YUN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "541-677-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "MD26302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500614895",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ENT Associates of Roseburg LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.