Active NPI
John Thomas Davis, LCSW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1215418983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-05771
- Practice address
- 1501 San Pedro Dr SE
Albuquerque, NM 87108 - Phone
- (505) 265-1711
- Fax
- (774) 441-6284
- NPI assigned
- Aug 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-05771 | NM | Primary |
| Clinical Social Worker | 1041C0700X | 119237 | MA |
Addresses
Primary practice location
1501 San Pedro Dr SE
Albuquerque, NM 87108
Mailing address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone (505) 265-1711
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 |
|---|---|---|---|
| 119237 | MA | MD | Clinical Social Worker |
| C-05771 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774915200000",
"number": "1215418983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 SAN PEDRO DR SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085153",
"telephone_number": "505-265-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 SAN PEDRO DR SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87108",
"telephone_number": "505-265-1711",
"fax_number": "774-441-6284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JOHN",
"middle_name": "THOMAS",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-22",
"last_updated": "2026-03-31",
"certification_date": "2026-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-05771",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "119237",
"primary": false
}
],
"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 Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.