CORNELL EYECARE GROUP, INC (NPI# 1982758868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982758868 |
| Entity Type | Organization |
| Organization Name | CORNELL EYECARE GROUP, INC |
| Other Organization Name | CORNELL EYECARE GROUP |
| Practice Address |
12955 Nw Cornell Rd Portland OR 97229-5863 |
| Practice Telephone | 5036435556 |
| Practice Fax Number | 5036412515 |
| Mailing Telephone | 5036435556 |
| Mailing Fax Number | 5036412515 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2008-09-23 |
| Authorized Official Name | DR. CHAD WAYNE LAWSON (PRESIDENT) |
| Authorized Official Telephone | 5036435556 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2784ATI | OR | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 18428-3 | 05 |
| Other Name | Type Code |
|---|---|
| Cornell Eyecare Group | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CORNELL EYECARE GROUP, INC. | 12955 Nw Cornell Rd, Portland, OR 97229 |
| Street Address |
12955 NW CORNELL RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-5863 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992859854 | Chad Wayne Lawson | Optometrist | 12955 Nw Cornell Rd, Portland, OR 97229-5863 | 2007-01-22 |
| 1811041734 | Raymond Roy Jr. | Optometrist | 12955 Nw Cornell Rd, Portland, OR 97229-5863 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376162008 | Eyestrong, LLC | Optometrist | 3934 Ne Mlk Jr Blvd Ste 101, Portland, OR 97212-1153 | 2020-04-13 |
| 1740816768 | Allison Kuo | Optometrist | 3710 Sw Us Veterans Hospital Rd Bldg 1008c140, Portland, OR 97239-2964 | 2020-03-21 |
| 1689235160 | Maja Krsmanovic | Optometrist | 14 Buca Run, Portland, ME 04103-1427 | 2019-06-25 |
| 1407416225 | Sarah Fowler | Optometrist | 605 S Broadway St, Portland, TN 37148-1619 | 2019-06-14 |
| 1720645302 | Ryan Steve Kucala | Optometrist | 520 Nw Lost Springs Ter # Unite203, Portland, OR 97229-6655 | 2019-05-20 |
| 1023575925 | Pacific Eye Group, PC | Optometrist | 1006 Lloyd Ctr, Portland, OR 97232-1266 | 2019-02-27 |
| 1811472749 | Carole Tong | Optometrist | 8136 Se Foster Rd Ste 260, Portland, OR 97206-4288 | 2018-09-26 |
| 1528580354 | Dr. Han Tran & Associates, P.C. | Optometrist | 12100 Se 82nd Ave, Portland, OR 97086-7755 | 2017-07-13 |
| 1306384128 | Daniel & Max, LLC | Optometrist | 8795 Sw Scholls Ferry Rd, Portland, OR 97223-4409 | 2017-02-01 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.