Individual provider Active NPI

Denise Chun

  • Family Medicine Physician
  • Woodburn, OR
National Provider Identifier
1902995376
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD24677 Issued in OR
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

Updated by the provider on Mar 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
019720006OtherREGENCE
232847MedicaidOR
911019392OtherCOMMERCIAL

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040227000995 OR Practitioner - Family Practice 6507753225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD24677ORMDFamily 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

Verify at the official NPI Registry.