Active NPI
John Richard Gunderman, M.D.
- Specialist
- Tampa, FL
National Provider Identifier
1861513640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME0017044
- Practice address
- 5106 N Armenia Ave
Suite 5
Tampa, FL 33603-1433 - Phone
- (813) 879-7816
- Fax
- (813) 875-0837
- NPI assigned
- Apr 2, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | ME0017044 | FL | Primary |
Addresses
Primary practice location
5106 N Armenia Ave
Suite 5
Tampa, FL 33603-1433
Mailing address
5106 N Armenia Ave
Suite 5
Tampa, FL 33603-1433
Phone (813) 879-7816
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 9, 2013 through Oct 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0017044 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1861513640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5106 N ARMENIA AVE",
"address_2": "SUITE 5",
"city": "TAMPA",
"state": "FL",
"postal_code": "336031433",
"telephone_number": "813-879-7816",
"fax_number": "813-875-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5106 N ARMENIA AVE",
"address_2": "SUITE 5",
"city": "TAMPA",
"state": "FL",
"postal_code": "336031433",
"telephone_number": "813-879-7816",
"fax_number": "813-875-0837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDERMAN",
"first_name": "JOHN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "ME0017044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.