NPIMap

Organization Active NPI

Thrive Age

  • In Home Supportive Care Agency
  • Portland, OR
National Provider Identifier
1043086002
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
THRIVE AGE
Practice address
3939 N Marine Dr Slip 2
Portland, OR 97217-7769
Phone
(503) 860-1655
NPI assigned
Nov 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Polly Jean Bangs
Title
Owner/Operator
Phone
(503) 860-1655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

3939 N Marine Dr Slip 2
Portland, OR 97217-7769

Mailing address

3939 N Marine Dr Slip 2
Portland, OR 97217-7769
Phone (503) 860-1655

Other names 1

  • Thrive Guides Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1043086002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 N MARINE DR SLIP 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177769",
            "telephone_number": "503-860-1655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 N MARINE DR SLIP 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972177769",
            "telephone_number": "503-860-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE AGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "BANGS",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "503-860-1655"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thrive Guides",
            "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 Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.