Individual provider Active NPI

Carvorggio Brown

  • Home Health Aide
  • Omaha, NE
National Provider Identifier
1104610880
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
8611 Blondo St Ste 1
Omaha, NE 68134-6159
Phone
(402) 830-9090
NPI assigned
Apr 7, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X
Personal Care Attendant 3747P1801X
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

8611 Blondo St Ste 1
Omaha, NE 68134-6159

Mailing address

8611 Blondo St Ste 1
Omaha, NE 68134-6159
Phone (402) 830-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eco Supportive Living Adult Companion CurrentSince Apr 13, 2025 Accepting new patients

Locations

8611 Blondo St
Ste 1
Omaha, NE 68134
Phone (402) 830-9090

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1104610880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8611 BLONDO ST STE 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346159",
            "telephone_number": "402-830-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8611 BLONDO ST STE 1",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681346159",
            "telephone_number": "402-830-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CARVORGGIO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.