Individual provider Active NPI

C. John Chunn, MD

  • Pediatric Infectious Diseases Physician
  • Bend, OR
National Provider Identifier
1629057997
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD09323 Issued in OR
Practice address
2200 NE Professional CT
Bend, OR 97701
Phone
(541) 389-6313
Fax
(541) 389-8760
NPI assigned
Jan 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X MD09323 OR Primary

Addresses

Primary practice location

2200 NE Professional CT
Bend, OR 97701

Mailing address

2200 NE Professional CT.
Bend, OR 97701
Phone (541) 389-6313

Other identifiers 1

IdentifierTypeStateIssuer
048827MedicaidOR

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Oregon Pediatric Associates PastSince Dec 12, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jchunn@copa.gwaydirect.com

Organizations & group practices 1

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1629057997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NE PROFESSIONAL CT.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-6313",
            "fax_number": "541-389-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE PROFESSIONAL CT",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97701",
            "telephone_number": "541-389-6313",
            "fax_number": "541-389-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNN",
        "first_name": "C. JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "OR",
            "license": "MD09323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048827",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; 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.