Organization Active NPI

Doris C Gundersen M D P C

  • Psychiatry Physician
  • Denver, CO
National Provider Identifier
1972800787
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30452 Issued in CO
Legal business name
DORIS C GUNDERSEN M D P C
Practice address
425 S Cherry St
Suite 810
Denver, CO 80246-1226
Phone
(303) 717-8516
Fax
(303) 738-0644
NPI assigned
Feb 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

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

Authorized official

Name
Doris Christine Gundersen, M.D.NPI 1841311057
Title
Owner
Phone
(303) 717-8516

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 30452 CO Primary

Addresses

Primary practice location

425 S Cherry St
Suite 810
Denver, CO 80246-1226

Mailing address

425 S Cherry St
Suite 810
Denver, CO 80246-1226
Phone (303) 717-8516

Other identifiers 1

IdentifierTypeStateIssuer
1841311057OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121009000308 CO Part B Supplier - Clinic/Group Practice 7012166945 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO

National Provider Directory

National Provider Directory

Locations

425 S Cherry St
Ste 810
Glendale, CO 80246
Phone (303) 717-8516

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1972800787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S CHERRY ST",
            "address_2": "SUITE 810",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461226",
            "telephone_number": "303-717-8516",
            "fax_number": "303-738-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S CHERRY ST",
            "address_2": "SUITE 810",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802461226",
            "telephone_number": "303-717-8516",
            "fax_number": "303-738-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DORIS C GUNDERSEN M D P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-15",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "GUNDERSEN",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-717-8516",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "30452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841311057",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.