ALEXA NICOLE THAVORN I (NPI# 1083205074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083205074 |
| Entity Type | Individual |
| Full Name | ALEXA NICOLE THAVORN I |
| Gender | Female |
| Credential | OD |
| Practice Address | 11805 Nw Cedar Falls Dr Ste 105 Portland OR 97229-2780 |
| Practice Telephone | 5037470265 |
| Mailing Address | 2621 Ne 7th Ave Apt 404 Portland OR 97212-3179 |
| Mailing Telephone | 7144782676 |
| Certification Date | 2021-02-01 |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2021-02-01 |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | Taxonomy Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ATI4556 | OR | Eye and Vision Services Providers |
| Street Address | 11805 NW CEDAR FALLS DR STE 105 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-2780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558848333 | Kelsey Mcevoy | Dentist | 11805 Nw Cedar Falls Dr Ste 101, Portland, OR 97229-2780 | 2018-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548858442 | Cady Mathews | Pharmacist | 24 Nw Lost Springs Terr #36, Portland, OR 97229 | 2021-01-06 |
| 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 · Family | 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 · Jenny Lavonne Miller | Counselor · Mental Health | 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 · Crystal L Mesillas | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 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 | 3934 Ne Mlk Jr Blvd Ste 101, Portland, OR 97212-1153 | 2020-04-13 | |
| 1740816768 | Allison Kuo | 3710 Sw Us Veterans Hospital Rd Bldg 1008c140, Portland, OR 97239-2964 | 2020-03-21 | |
| 1194355123 | Irina Stignei Od PC · Tabor Vision | 1433 Ne 69th Ave, Portland, OR 97213-5301 | 2020-01-17 | |
| 1689235160 | Maja Krsmanovic | 14 Buca Run, Portland, ME 04103-1427 | 2019-06-25 | |
| 1407416225 | Sarah Fowler | 605 S Broadway St, Portland, TN 37148-1619 | 2019-06-14 | |
| 1720645302 | Ryan Steve Kucala | 520 Nw Lost Springs Ter # Unite203, Portland, OR 97229-6655 | 2019-05-20 | |
| 1023575925 | Pacific Eye Group, PC · Pacific Eye Group, PC | 1006 Lloyd Ctr, Portland, OR 97232-1266 | 2019-02-27 | |
| 1811472749 | Carole Tong | 8136 Se Foster Rd Ste 260, Portland, OR 97206-4288 | 2018-09-26 | |
| 1528580354 | Dr. Han Tran & Associates, P.C. · 82nd Eyecare | 12100 Se 82nd Ave, Portland, OR 97086-7755 | 2017-07-13 | |
| 1306384128 | Daniel & Max, LLC · Stanton Optical | 8795 Sw Scholls Ferry Rd, Portland, OR 97223-4409 | 2017-02-01 | |
| Find all providers in PORTLAND | ||||
| City | PORTLAND |
| Zip Code | 97229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073815700 | Alexa Nicole Kyle · Alexa Nicole Morgese | Physician Assistant | 45 Reade Place, 2nd Floor, Poughkeepsie, NY 12601 | 2010-12-01 |
| 1427396670 | Alexa Nicole Grzywa · Alexa Nicole Whitefoot | Physician Assistant | 1 Edmundson Pl Ste 306, Council Bluffs, IA 51503-4620 | 2013-01-23 |
| 1104362797 | Nicole Alexa Williams · Nicole Alexa Hemmann | Pharmacist | 503 N 21st St, Camp Hill, PA 17011-2204 | 2017-01-06 |
| 1285287797 | Phramaha Thavorn Popan | Technician · Personal Care Attendant | 3175 S Eastern Ave, Las Vegas, NV 89169-3308 | 2019-07-23 |
| 1891807855 | Thavorn Lorungrochana | Specialist | 4649 Nannie Helen Burroughs Ave Ne, Washington, DC 20019-3662 | 2006-08-31 |
| 1346765518 | Alexa Nicole Fox | Optometrist | 351 Evelyn St Ste 301, Paramus, NJ 07652-2901 | 2017-08-09 |
| 1275051435 | Alexa Nicole Eugene | Behavior Technician | 329 E 149th St Fl 4, Bronx, NY 10451-5626 | 2017-09-07 |
| 1104481050 | Alexa Nicole Black | Student in an Organized Health Care Education/Training Program | 500 S Preston St Rm 305, Louisville, KY 40202-1702 | 2019-05-07 |
| 1356736904 | Alexa Nicole Hemmer | Student in an Organized Health Care Education/Training Program | 231 Stonebridge Way, Mundelein, IL 60060-3393 | 2015-03-31 |
| 1700390218 | Courtney Nicole Shields | Counselor · Addiction (Substance Use Disorder) | 805 Alexa Dr Ste D, Mt Sterling, KY 40353-1000 | 2017-11-20 |
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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.