Active NPI
Denise Chun
- Family Medicine Physician
- Woodburn, OR
National Provider Identifier
1902995376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD24677
- Practice address
- 1175 Mount Hood Ave
Woodburn, OR 97071-9060 - Phone
- (503) 982-2000
- Fax
- (503) 982-0660
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD24677 | OR | Primary |
Addresses
Primary practice location
1175 Mount Hood Ave
Woodburn, OR 97071-9060
Mailing address
1175 Mount Hood Ave
Woodburn, OR 97071-9060
Phone (503) 982-2000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019720006 | Other | REGENCE | |
| 232847 | Medicaid | OR | |
| 911019392 | Other | COMMERCIAL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dchun4814@yvfwc.direct-ci.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040227000995 | OR | Practitioner - Family Practice | 6507753225 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD24677 | OR | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1902995376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 MOUNT HOOD AVE",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970719060",
"telephone_number": "503-982-2000",
"fax_number": "503-982-0660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 MOUNT HOOD AVE",
"city": "WOODBURN",
"state": "OR",
"postal_code": "970719060",
"telephone_number": "503-982-2000",
"fax_number": "503-982-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUN",
"first_name": "DENISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2021-03-08",
"certification_date": "2021-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD24677",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "019720006",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232847",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMMERCIAL",
"identifier": "911019392",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dchun4814@yvfwc.direct-ci.com",
"affiliation": "N",
"endpointDescription": "YVFWC Direct Email Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "1175 Mount Hood Ave",
"city": "Woodburn",
"state": "OR",
"country_code": "US",
"postal_code": "970719060",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Woodburn, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.