Active NPI
Ann Mary Slocum-Edmonds, O.D.
- Optometrist
- Portland, OR
National Provider Identifier
1194716449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2152T
- 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
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 | 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2152T | OR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molalla Vision Clinic PC | Optometrist | Current | Accepting new patients |
| D Gregory Luce OD PC | Optometrist | Current | 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.
-
- Corneal and Contact Management Optometrist
- Beaverton, OR
- NPI 1174610331
-
- Optometrist
- Molalla, OR
- NPI 1497931018
-
- Family Medicine Physician
- Peoria, IL
- NPI 1184670663
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.