Carson Holdings, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

15-2184 Issued in OR

Legal business name

CARSON HOLDINGS, LLC

Doing business as

Homewatch CareGivers of Portland

Practice address

3880 SE 8TH Ave Ste 110
Portland, OR 97202-3772

Phone

(503) 284-4440

Fax

(503) 281-4612

NPI assigned

Aug 13, 2018

Organization subpart

No

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

Authorized official

Name

Andy Delahunty

Title

Executive Vice President

Phone

(503) 284-4440

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Homewatch CareGivers of Portland Doing business as

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1356820906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-284-4440",
            "fax_number": "503-281-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-284-4440",
            "fax_number": "503-281-4612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARSON HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-13",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "DELAHUNTY",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "503-284-4440"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "15-2184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500657085",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500655816",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Homewatch CareGivers of Portland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne Davis Carruth, MS, LAC, DIPL OM
• Joshua David Carruthers
• Natoya S Carruthers, PA-C
• Terri Carsner
• Sal Jamie Carso, PA-S
• Caroline Carson
• Darlene Carson, RPH
• Eric Byron Carson
• James Wood Carson, PHD
• Janet Kathleen Carson, LPC

• In Home Supportive Care Agency in Portland, OR
• Providers in Portland, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.