Active NPI
Terry Alan Kunke, MD
- Ophthalmology Physician
- Oregon City, OR
National Provider Identifier
1831171883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- MD19254
- Practice address
- 1306 Division St
Oregon City, OR 97045-1523 - Phone
- (503) 656-4221
- Fax
- (503) 656-4249
- NPI assigned
- Nov 16, 2005
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | MD19254 | OR | Primary |
Addresses
Primary practice location
1306 Division St
Oregon City, OR 97045-1523
Mailing address
11086 SE Oak St
Milwaukie, OR 97222-6692
Phone (503) 557-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070685 | Medicaid | OR |
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 |
|---|---|---|---|
| MD19254 | OR | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1831171883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11086 SE OAK ST",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972226692",
"telephone_number": "503-557-2020",
"fax_number": "503-344-5110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 DIVISION ST",
"city": "OREGON CITY",
"state": "OR",
"postal_code": "970451523",
"telephone_number": "503-656-4221",
"fax_number": "503-656-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNKE",
"first_name": "TERRY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "OR",
"license": "MD19254",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "070685",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oregon City, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.