Tundike Gore, DNP, PMHNP, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

20211168NP-PP Issued in OR

Practice address

5305 River Rd N Ste B
Keizer, OR 97303-5324

Phone

(972) 765-7168

NPI assigned

Jul 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Tunde Gore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1346681020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 MINERAL SPRINGS DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750020616",
            "telephone_number": "972-765-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "972-765-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "TUNDIKE",
        "credential": "DNP, PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP123999",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202109011NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "20211168NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP-C NUMBER: F0613870",
            "identifier": "NP-C NUMBER: F061387",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TUNDE",
            "last_name": "GORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Golden Crane Counseling, LLC
• David Alexander Gonzalez, DPT, PT
• Susana Cortez Gonzalez, MSN, APRN, PMHNP-BC
• Janelle Gordon, PT
• Sara Lauren Gordon, MS, ATC
• Christopher Gosselin, DC
• Carly Gostanian
• Lavinia S Goto, RN, DHA
• Jori Beth Grady, DMD
• April J Graybill, L.M.T

• Psychiatric/Mental Health Nurse Practitioner in Keizer, OR
• Providers in Keizer, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.