Individual provider Active NPI

Shelley Jean Pajak, LMSW

  • Social Worker
  • Farmington, NM
National Provider Identifier
1255409678
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
M04980 Issued in NM
Practice address
501 Airport Dr Ste 253
Farmington, NM 87401-2646
Phone
(505) 325-2778
Fax
(505) 325-6171
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

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
Social Worker 104100000X M04980 NM Primary

Addresses

Primary practice location

501 Airport Dr Ste 253
Farmington, NM 87401-2646

Mailing address

2011 Troy King Rd # SP.433
Farmington, NM 87401-3158
Phone (505) 325-0935

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

LicenseStateTypeSpecialty
M04980NMMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255409678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 TROY KING RD # SP.433",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874013158",
            "telephone_number": "505-325-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 AIRPORT DR STE 253",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012646",
            "telephone_number": "505-325-2778",
            "fax_number": "505-325-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJAK",
        "first_name": "SHELLEY",
        "middle_name": "JEAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M04980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.