NPIMap

Organization Active NPI

Ardon Health, LLC

  • Specialty Pharmacy
  • Portland, OR
National Provider Identifier
1962832071
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
License
PHA-O1385 Issued in AK
Legal business name
ARDON HEALTH, LLC
Practice address
11835 NE Glenn Widing Dr
Portland, OR 97220-9057
Phone
(855) 425-4085
Fax
(855) 425-4096
NPI assigned
Nov 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Heather Chapman
Title
President
Phone
(503) 444-6529

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X PMP-1004 HI
Specialty Pharmacy 3336S0011X PCN.0002782 CT
Specialty Pharmacy 3336S0011X 64002411A IN
Specialty Pharmacy 3336S0011X PH28357 FL
Specialty Pharmacy 3336S0011X NRX1701250 DC
Specialty Pharmacy 3336S0011X 054.018529 IL
Specialty Pharmacy 3336S0011X NRP2008 CA
Specialty Pharmacy 3336S0011X A9-0002058 DE
Specialty Pharmacy 3336S0011X 46361MS ID
Specialty Pharmacy 3336S0011X PHA-O1385 AK Primary
Specialty Pharmacy 3336S0011X 22-103391 KS
Specialty Pharmacy 3336S0011X OSP.0006445 CO
Specialty Pharmacy 3336S0011X 4361 IA
Specialty Pharmacy 3336S0011X Y005898 AZ
Specialty Pharmacy 3336S0011X PHNR000256 GA

Addresses

Primary practice location

11835 NE Glenn Widing Dr
Portland, OR 97220-9057

Mailing address

11835 NE Glenn Widing Dr
Portland, OR 97220-9057
Phone (855) 425-4101

Other identifiers 17

IdentifierTypeStateIssuer
1609651MedicaidAK
1962832071MedicaidMT
19628790MedicaidNM
7100529010MedicaidKY
8980063-00MedicaidMD
10026742100MedicaidNE
1962832071MedicaidID
2034813MedicaidWA
7R2854MedicaidSC
2143280OtherPK
3006801MedicaidUT
365515MedicaidAZ
9000163242MedicaidCO
1035155530001MedicaidPA
1962832071MedicaidNC
500668204MedicaidOR
1962832071MedicaidVA

Other names 1

  • Ardon Health, LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140415001242 OR Part B Supplier - Pharmacy 3870725310 Practice locations: Portland, OR
O20160727000546 OR DME Supplier - Pharmacy 3870725310 Practice locations: Portland, OR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ardon Health LLC11835 NE Glenn Widing Dr, Portland, OR 97220-9057(855) 425-4101 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Mar 1, 2014

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11835 NE Glenn Widing Dr
Portland, OR 97220
Phone (855) 425-4085

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1962832071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11835 NE GLENN WIDING DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209057",
            "telephone_number": "855-425-4101",
            "fax_number": "855-425-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 NE GLENN WIDING DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209057",
            "telephone_number": "855-425-4085",
            "fax_number": "855-425-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARDON HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-26",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-444-6529"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "HI",
            "license": "PMP-1004",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CT",
            "license": "PCN.0002782",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "IN",
            "license": "64002411A",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "FL",
            "license": "PH28357",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "DC",
            "license": "NRX1701250",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "IL",
            "license": "054.018529",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CA",
            "license": "NRP2008",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "DE",
            "license": "A9-0002058",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "ID",
            "license": "46361MS",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AK",
            "license": "PHA-O1385",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "KS",
            "license": "22-103391",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "CO",
            "license": "OSP.0006445",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "IA",
            "license": "4361",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AZ",
            "license": "Y005898",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "GA",
            "license": "PHNR000256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609651",
            "state": "AK"
        },
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            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962832071",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19628790",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100529010",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8980063-00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026742100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962832071",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034813",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7R2854",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143280",
            "state": null
        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "3006801",
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        },
        {
            "code": "05",
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            "identifier": "365515",
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        },
        {
            "code": "05",
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            "issuer": null,
            "identifier": "9000163242",
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        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035155530001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962832071",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500668204",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962832071",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ardon Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ardon Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.