Active NPI
Wilford Crain III
- Social Worker
- Albuquerque, NM
National Provider Identifier
1295388130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- C-09484
- Practice address
- 1501 San Pedro Dr SE
Albuquerque, NM 87108-5153 - Phone
- (505) 265-1711
- NPI assigned
- Jul 19, 2019
- Last updated
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | C-09484 | NM | Primary |
| Clinical Social Worker | 1041C0700X | NU |
Addresses
Primary practice location
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Mailing address
1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone (505) 265-1711
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Albuquerque | Albuquerque VAMC | |
| CONNECT URL | Albuquerque | Health Information Exchange (HIE) | Albuquerque VAMC |
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 |
|---|---|---|---|
| C-09484 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1295388130",
"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": "871085153",
"telephone_number": "505-265-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRAIN",
"first_name": "WILFORD",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-19",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "C-09484",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Albuquerque",
"affiliation": "Y",
"affiliationName": "Albuquerque VAMC",
"address_1": "1501 San Pedro Dr SE",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871085153",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Albuquerque",
"affiliation": "Y",
"affiliationName": "Albuquerque VAMC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1501 San Pedro Dr SE",
"city": "Albuquerque",
"state": "NM",
"country_code": "US",
"postal_code": "871085153",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.