Active NPI
Carrie Robersone
- Community Health Worker
- Portland, OR
National Provider Identifier
1649060492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- THW000108287
- Practice address
- 5329 NE Martin Luther King Blvd
Portland, OR 97211-3237 - Phone
- (206) 458-4342
- NPI assigned
- May 7, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | THW000108287 | OR | Primary |
Addresses
Primary practice location
5329 NE Martin Luther King Blvd
Portland, OR 97211-3237
Mailing address
5021 NE 13TH Ave
Portland, OR 97211-5079
Phone (206) 458-4342
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| THW000108287 | OR | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1649060492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5021 NE 13TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972115079",
"telephone_number": "206-458-4342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5329 NE MARTIN LUTHER KING BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972113237",
"telephone_number": "206-458-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERSONE",
"first_name": "CARRIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-07",
"last_updated": "2025-05-07",
"certification_date": "2025-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "OR",
"license": "THW000108287",
"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 May 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.