Individual provider Active NPI

Carol Elizabeth Gunn, M.D.

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Portland, OR
National Provider Identifier
1457401176
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
License
MD26333 Issued in OR
Practice address
9370 SW Greenburg Rd
Suite 101
Portland, OR 97223-5442
Phone
(503) 246-7030
Fax
(503) 246-0429
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X MD26333 OR Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X A86540 CA
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X 43420 CO

Addresses

Primary practice location

9370 SW Greenburg Rd
Suite 101
Portland, OR 97223-5442

Mailing address

9370 SW Greenburg Rd
Suite 101
Portland, OR 97223-5442
Phone (503) 246-7030

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
A86540CAMDPreventive Medicine/Occupational Environmental Medicine Physician
43420COMDPreventive Medicine/Occupational Environmental Medicine Physician
MD26333ORMDPreventive Medicine/Occupational Environmental Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457401176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235442",
            "telephone_number": "503-246-7030",
            "fax_number": "503-246-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235442",
            "telephone_number": "503-246-7030",
            "fax_number": "503-246-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNN",
        "first_name": "CAROL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "OR",
            "license": "MD26333",
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "A86540",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CO",
            "license": "43420",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.