NPIMap

Individual provider Active NPI

Erik William Gunderson, M.D.

  • Addiction Medicine (Preventive Medicine) Physician
  • Charlottesville, VA
National Provider Identifier
1316033350
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
License
0101244180 Issued in VA
Practice address
1007 E High Street
Center for Wellness and Change, LLC
Charlottesville, VA 22902
Phone
(434) 202-8612
Fax
(434) 321-5181
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 212008 NY
Psychiatry Physician 2084P0800X 0101244180 VA
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 0101244180 VA Primary

Addresses

Primary practice location

1007 E High Street
Center for Wellness and Change, LLC
Charlottesville, VA 22902

Mailing address

1702 Yorktown Drive
Charlottesville, VA 22901
Phone (434) 202-8612

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101244180VAMDAddiction Medicine (Preventive Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Wellness & Change, LLC Psychiatry Current Accepting new patients
The New York and Presbyterian Hospital Past Accepting new patients
The New York and Presbyterian Hospital Internal Medicine Past Accepting new patients

Locations

1007 E High St
Charlottesville, VA 22902
Phone (434) 202-8612

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1316033350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 YORKTOWN DRIVE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22901",
            "telephone_number": "434-202-8612",
            "fax_number": "434-321-5181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E HIGH STREET",
            "address_2": "CENTER FOR WELLNESS AND CHANGE, LLC",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "22902",
            "telephone_number": "434-202-8612",
            "fax_number": "434-321-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "ERIK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "212008",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0101244180",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "VA",
            "license": "0101244180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.