Fredrick Aundrae Durr, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA157429 Issued in OR

Practice address

375 SE NE Norton Lane
Suite a
McMinnville, OR 97128

Phone

(503) 472-9002

NPI assigned

Jun 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399593600000",
    "number": "1700149341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12535 SE KIMSEY RD",
            "city": "DAYTON",
            "state": "OR",
            "postal_code": "971148407",
            "telephone_number": "503-864-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 SE NE NORTON LANE",
            "address_2": "SUITE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "97128",
            "telephone_number": "503-472-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURR",
        "first_name": "FREDRICK",
        "middle_name": "AUNDRAE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2014-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA157429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PA LICENSE NUMBER",
            "identifier": "PA157429",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Kathleen Dumonceaux
• Angelamarie Jorie Dunn
• Camron Chalmers Dunn, LMT
• Caroline Dunn, MBA, RDN, LD
• Deborah Gayle Dunn, MSW, CSWA
• Rachel Dyer
• Melissa Darling Earnest, FNP
• Jennifer Marie Eby, LPN/IP
• Mandi Kaye Echeverria, CRM
• Richard I Ecker, M.D.

• Physician Assistant in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.