Active NPI
Jack Matthew Gunn, MD
- Anesthesiology Physician
- Yakima, WA
National Provider Identifier
1831150754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD00039736
- Practice address
- 110 S 9TH Ave
Yakima, WA 98902-3315 - Phone
- (509) 574-4440
- Fax
- (509) 574-4481
- NPI assigned
- Mar 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD00039736 | WA | Primary |
Addresses
Primary practice location
110 S 9TH Ave
Yakima, WA 98902-3315
Mailing address
732 Summitview Ave
#633
Yakima, WA 98902-3032
Phone (509) 573-3448
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8313694 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD18010 | OR | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yakima Hma Physician Management LLC | Anesthesiology | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Yakima, WA
- NPI 1730139510
Anesthesiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1831150754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "732 SUMMITVIEW AVE",
"address_2": "#633",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023032",
"telephone_number": "509-573-3448",
"fax_number": "509-574-4481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S 9TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989023315",
"telephone_number": "509-574-4440",
"fax_number": "509-574-4481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN",
"first_name": "JACK",
"middle_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-30",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD00039736",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8313694",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.