Active NPI
Marco Carter, QMHA
- Adult Companion
- Portland, OR
National Provider Identifier
1114469210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- Practice address
- 847 NE 19TH Ave
Portland, OR 97232-2684 - Phone
- (503) 238-0769
- NPI assigned
- Nov 7, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Adult Companion | 372600000X | Primary |
Addresses
Primary practice location
847 NE 19TH Ave
Portland, OR 97232-2684
Mailing address
PO Box 8459
Portland, OR 97207-8459
Other practice location 1
13850 SE Autumn Ridge Ter
Milwaukie, OR 97267-2150
Phone (503) 974-9250
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbiacare Services | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1982140588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1114469210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322684",
"telephone_number": "503-238-0769"
}
],
"practiceLocations": [
{
"address_1": "13850 SE Autumn Ridge Ter",
"address_purpose": "LOCATION",
"city": "Milwaukie",
"state": "OR",
"postal_code": "972672150",
"country_code": "US",
"telephone_number": "503-974-9250",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARTER",
"first_name": "MARCO",
"name_prefix": "Mr.",
"credential": "QMHA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-07",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.