NPIMap

Individual provider Active NPI

Angela Stock Nairn, MD

  • Family Medicine Physician
  • Astoria, OR
National Provider Identifier
1417909094
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD22457 Issued in OR
Practice address
2055 Exchange St
Ste 190
Astoria, OR 97103-3419
Phone
(503) 325-5300
Fax
(503) 325-5400
NPI assigned
May 16, 2006
Last updated
Dec 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD22457 OR Primary

Addresses

Primary practice location

2055 Exchange St
Ste 190
Astoria, OR 97103-3419

Mailing address

2055 Exchange St
Ste 190
Astoria, OR 97103-3419
Phone (503) 325-5300

Other identifiers 1

IdentifierTypeStateIssuer
288188MedicaidOR

Other names 1

  • Angela Marie Stock Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100216000942 OR Practitioner - Family Practice 8123195708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 1992
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Pacific Family Medicine LLPGroup PAC ID 6406829407, 2 clinicians

Practice addresses (Care Compare)

2055 Exchange St
Suite 190
Astoria, OR 97103-3419

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD22457ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Family Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1417909094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 EXCHANGE ST",
            "address_2": "STE 190",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033419",
            "telephone_number": "503-325-5300",
            "fax_number": "503-325-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 EXCHANGE ST",
            "address_2": "STE 190",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971033419",
            "telephone_number": "503-325-5300",
            "fax_number": "503-325-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIRN",
        "first_name": "ANGELA",
        "middle_name": "STOCK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD22457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288188",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "STOCK",
            "middle_name": "MARIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.