Active NPI
Pam Ebert, O.D.
- Optometrist
- Springfield, OR
National Provider Identifier
1124155528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3484AT
- Practice address
- 1871 2ND St
Springfield, OR 97477-2121 - Phone
- (541) 741-0122
- Fax
- (541) 988-3401
- NPI assigned
- Feb 27, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3484AT | OR | Primary |
Addresses
Primary practice location
1871 2ND St
Springfield, OR 97477-2121
Mailing address
1871 2ND St
Springfield, OR 97477-2121
Phone (541) 741-0122
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R174133 | Other | OR | PTAN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3484AT | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770854400000",
"number": "1124155528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1871 2ND ST",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772121",
"telephone_number": "541-741-0122",
"fax_number": "541-988-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1871 2ND ST",
"city": "SPRINGFIELD",
"state": "OR",
"postal_code": "974772121",
"telephone_number": "541-741-0122",
"fax_number": "541-988-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EBERT",
"first_name": "PAM",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2026-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "3484AT",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "R174133",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.