Active NPI
Roseann Knowles, OD
- Optometrist
- Monmouth, OR
National Provider Identifier
1144378233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1548AT
- Practice address
- 405 Boyd LN
Monmouth, OR 97361-1611 - Phone
- (503) 838-1244
- Fax
- (503) 837-1047
- NPI assigned
- Jan 8, 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 | 1548AT | OR | Primary |
Addresses
Primary practice location
405 Boyd LN
Monmouth, OR 97361-1611
Mailing address
506 Main St
Dallas, OR 97338-1915
Phone (503) 623-9233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290312 | Medicaid | OR |
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 |
|---|---|---|---|
| 1548AT | OR | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1144378233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "506 MAIN ST",
"city": "DALLAS",
"state": "OR",
"postal_code": "973381915",
"telephone_number": "503-623-9233",
"fax_number": "503-623-9233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 BOYD LN",
"city": "MONMOUTH",
"state": "OR",
"postal_code": "973611611",
"telephone_number": "503-838-1244",
"fax_number": "503-837-1047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLES",
"first_name": "ROSEANN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OR",
"license": "1548AT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "290312",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monmouth, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.