Active NPI
William Ronnie Nunley, MD
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1861404089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL15343
- Practice address
- 1526 NE Alberta St
#222
Portland, OR 97211-5046 - Phone
- (502) 494-9000
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL15343 | OR | Primary |
Addresses
Primary practice location
1526 NE Alberta St
#222
Portland, OR 97211-5046
Mailing address
1526 NE Alberta St
#222
Portland, OR 97211-5046
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Aug 2, 2023 through Aug 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL15343 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300233600000",
"number": "1861404089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1526 NE ALBERTA ST",
"address_2": "#222",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972115046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1526 NE ALBERTA ST",
"address_2": "#222",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972115046",
"telephone_number": "502-494-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUNLEY",
"first_name": "WILLIAM",
"middle_name": "RONNIE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2011-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "LL15343",
"primary": true
}
],
"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 Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.