Individual provider Active NPI

Joey Blue, LISW

  • Clinical Social Worker
  • Taos, NM
National Provider Identifier
1073520813
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-4401 Issued in NM
Practice address
822B Paseo del Pubelo Sur
Taos, NM 87571
Phone
(505) 758-9511
Fax
(505) 758-9511
NPI assigned
Aug 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-4401 NM Primary

Addresses

Primary practice location

822B Paseo del Pubelo Sur
Taos, NM 87571

Mailing address

PO Box 1840
Ranchos de Taos, NM 87557-1840
Phone (505) 758-9511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111115000440 NM Practitioner - Clinical Social Worker 7517131220 Practice locations: Taos, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073520813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1840",
            "city": "RANCHOS DE TAOS",
            "state": "NM",
            "postal_code": "875571840",
            "telephone_number": "505-758-9511",
            "fax_number": "505-758-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822B PASEO DEL PUBELO SUR",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "505-758-9511",
            "fax_number": "505-758-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "JOEY",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-4401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

Verify at the official NPI Registry.