Active NPI
Ebon Scott Alley, LICSW
- Social Worker
- Fe Warren Afb, WY
National Provider Identifier
1265427868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 11902
- Practice address
- 6900 Alden Dr
90 MDG
Fe Warren Afb, WY 82005-3906 - Phone
- (307) 773-2998
- Fax
- (307) 773-4721
- NPI assigned
- Sep 20, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 11902 | MA | Primary |
Addresses
Primary practice location
6900 Alden Dr
90 MDG
Fe Warren Afb, WY 82005-3906
Mailing address
7924 Siringo Pass
Austin, TX 78749-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11902 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331251200000",
"number": "1265427868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7924 SIRINGO PASS",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787492727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 ALDEN DR",
"address_2": "90 MDG",
"city": "FE WARREN AFB",
"state": "WY",
"postal_code": "820053906",
"telephone_number": "307-773-2998",
"fax_number": "307-773-4721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEY",
"first_name": "EBON",
"middle_name": "SCOTT",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2012-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "11902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fe Warren Afb, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.