Active NPI
Sacha Christine Bush
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1134748833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-11140
- Practice address
- 5400 Gibson Blvd SE Ste 11
Albuquerque, NM 87108-5182 - Phone
- (505) 982-3113
- Fax
- (505) 982-2462
- NPI assigned
- Apr 13, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-11140 | NM | Primary |
Addresses
Primary practice location
5400 Gibson Blvd SE Ste 11
Albuquerque, NM 87108-5182
Mailing address
6134 4TH St NW Apt 72
Los Ranchos, NM 87107-5354
Phone (505) 850-4995
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200605000305 | NM | Practitioner - Clinical Social Worker | 6800217514 | Practice locations: Los Ranchos, NM |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-11140 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1134748833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6134 4TH ST NW APT 72",
"city": "LOS RANCHOS",
"state": "NM",
"postal_code": "871075354",
"telephone_number": "505-850-4995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 GIBSON BLVD SE STE 11",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085182",
"telephone_number": "505-982-3113",
"fax_number": "505-982-2462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSH",
"first_name": "SACHA",
"middle_name": "CHRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-13",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-11140",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.