Organization Active NPI

Support Is Apparent, LLC

  • Clinical Social Worker
  • Sandia Park, NM
National Provider Identifier
1053820902
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUPPORT IS APPARENT, LLC
Practice address
9 Gaudian Loop
Sandia Park, NM 87047-9555
Phone
(505) 620-2119
Fax
(505) 445-4504
NPI assigned
Sep 22, 2017
Last updated
Jan 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Adrianna Gallegos, LCSWNPI 1427342864
Title
Owner/Provider
Phone
(505) 226-1800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

9 Gaudian Loop
Sandia Park, NM 87047-9555

Mailing address

11600 Haines Ave NE
Albuquerque, NM 87112-4452
Phone (505) 620-2119

Other identifiers 1

IdentifierTypeStateIssuer
75700221MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180313000957 NM Part B Supplier - Clinic/Group Practice 7719249655 Receives reassigned benefits from 2 practitioners
Practice locations: Sandia Park, NM

National Provider Directory

National Provider Directory

Locations

11600 Haines Ave NE
Albuquerque, NM 87112

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1053820902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 HAINES AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124452",
            "telephone_number": "505-620-2119",
            "fax_number": "505-445-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 GAUDIAN LOOP",
            "city": "SANDIA PARK",
            "state": "NM",
            "postal_code": "870479555",
            "telephone_number": "505-620-2119",
            "fax_number": "505-445-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT IS APPARENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "ADRIANNA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "505-226-1800",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75700221",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandia Park, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.