Angela Ardiss, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2506ATI Issued in OR

Practice address

14740 NW Cornell Rd Ste 110
Portland, OR 97229-5400

Phone

(503) 645-8002

Fax

(503) 645-8002

NPI assigned

Apr 14, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Lake Oswego Vision Clinic LLC

  • Optometrist
  • Lake Oswego, OR
  • NPI 1750506937
  NPD (past)
• Willow Creek Eye Care Inc.

  • Corneal and Contact Management Optometrist
  • Portland, OR
  • NPI 1598000903
  NPD (past)

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

{
    "created_epoch": "1239667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1073756573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14740 NW CORNELL RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295400",
            "telephone_number": "503-645-8002",
            "fax_number": "503-645-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14740 NW CORNELL RD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295400",
            "telephone_number": "503-645-8002",
            "fax_number": "503-645-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDISS",
        "first_name": "ANGELA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-14",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2506ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Archodominion
• Joseph Arcudi, QMHP
• Emily Anne Ardent, LPC
• Jason Alberto Ardiles
• Claire Ardis, MD
• Douglas Arditti, CRNA
• Eric Alexander Ardman, MD
• Ardon Health, LLC
• Andrew Joseph Arehart
• Alyssa Arella

• Optometrist in Portland, OR
• Providers in Portland, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; 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.