Individual provider Active NPI

Edmund Reed Gurney Jr., MD

  • Family Medicine Physician
  • Myrtle Point, OR
National Provider Identifier
1952385684
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD10881 Issued in OR
Practice address
324 4TH Street
Myrtle Point, OR 97458-1066
Phone
(541) 572-2111
Fax
(541) 572-5743
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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 MD10881 OR Primary

Addresses

Primary practice location

324 4TH Street
Myrtle Point, OR 97458-1066

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-0000
Phone (541) 267-5151

Other identifiers 6

IdentifierTypeStateIssuer
1407812365OtherORNBMC NPI NUMBER-GROUP
930635514OtherORGROUP TAX NUMBER
P00288564OtherORRR MEDICARE PTAN NUMBER
R0000WFBTVOtherORGROUP PIN NUMBER
234328MedicaidOR
CB3544OtherORRR MEDICARE GROUP NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1952385684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974200000",
            "telephone_number": "541-267-5151",
            "fax_number": "541-266-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 4TH STREET",
            "city": "MYRTLE POINT",
            "state": "OR",
            "postal_code": "974581066",
            "telephone_number": "541-572-2111",
            "fax_number": "541-572-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURNEY",
        "first_name": "EDMUND",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD10881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBMC NPI NUMBER-GROUP",
            "identifier": "1407812365",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX NUMBER",
            "identifier": "930635514",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PTAN NUMBER",
            "identifier": "P00288564",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN NUMBER",
            "identifier": "R0000WFBTV",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234328",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NUMBER",
            "identifier": "CB3544",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.