Active NPI
Jessica L Duby, LMSW
- Social Worker
- Holloman Afb, NM
National Provider Identifier
1295067387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M-07534
- Practice address
- 49TH Medical Group/SGHW
280 First Street
Holloman Afb, NM 88330-8273 - Phone
- (575) 572-5880
- Fax
- (575) 572-3003
- NPI assigned
- Feb 1, 2010
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | M-07534 | NM | Primary |
Addresses
Primary practice location
49TH Medical Group/SGHW
280 First Street
Holloman Afb, NM 88330-8273
Mailing address
49TH Medical Group/SGHW
280 First Street
Holloman Afb, NM 88330-8273
Phone (575) 572-5880
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 |
|---|---|---|---|
| M-07534 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408665600000",
"number": "1295067387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49TH MEDICAL GROUP/SGHW",
"address_2": "280 FIRST STREET",
"city": "HOLLOMAN AFB",
"state": "NM",
"postal_code": "883308273",
"telephone_number": "575-572-5880",
"fax_number": "575-572-3003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49TH MEDICAL GROUP/SGHW",
"address_2": "280 FIRST STREET",
"city": "HOLLOMAN AFB",
"state": "NM",
"postal_code": "883308273",
"telephone_number": "575-572-5880",
"fax_number": "575-572-3003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBY",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-01",
"last_updated": "2014-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-07534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holloman Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.