Individual provider Active NPI

Ann Mary Slocum-Edmonds, O.D.

  • Optometrist
  • Portland, OR
National Provider Identifier
1194716449
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2152T Issued in OR
Practice address
3246 N Lombard St
Portland, OR 97217-1206
Phone
(503) 285-1671
Fax
(503) 285-7859
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2152T OR Primary

Addresses

Primary practice location

3246 N Lombard St
Portland, OR 97217-1206

Mailing address

1987 SW 16TH Ave
Portland, OR 97201-6016
Phone (503) 285-1671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070215000081 OR Practitioner - Optometry 3971502535 Reassigns benefits to 2 organizations
Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
D Gregory Luce OD PCGroup PAC ID 3678562071, 4 clinicians

Practice addresses (Care Compare)

14667 SW Teal Blvd
Beaverton, OR 97007-6194
Phone (503) 579-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2152TORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Molalla Vision Clinic PC Optometrist CurrentSince Oct 21, 2019 Accepting new patients
D Gregory Luce OD PC Optometrist CurrentSince Sep 14, 2016 Accepting new patients
Methodist Medical Center of Illinois Past Accepting new patients

Locations

14667 SW Teal Blvd
Beaverton, OR 97007
Phone (503) 579-2020

2306 SE Washington St
Milwaukie, OR 97222
Phone (503) 654-3212

502 E Main St
Molalla, OR 97038
Phone (503) 829-9186

Organizations & group practices 3

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1194716449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 SW 16TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972016016",
            "telephone_number": "503-285-1671",
            "fax_number": "503-285-7859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3246 N LOMBARD ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972171206",
            "telephone_number": "503-285-1671",
            "fax_number": "503-285-7859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOCUM-EDMONDS",
        "first_name": "ANN",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2152T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.