Active NPI
Adrian Fernando Cordova
- Behavior Technician
- Albuquerque, NM
National Provider Identifier
1306554845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 2428 Morris St NE
Albuquerque, NM 87112-1661 - Phone
- (505) 357-4853
- NPI assigned
- Nov 14, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NM | Primary |
Addresses
Primary practice location
2428 Morris St NE
Albuquerque, NM 87112-1661
Mailing address
2428 Morris St NE
Albuquerque, NM 87112-1661
Phone (505) 357-4853
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Medicaid | NM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1306554845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2428 MORRIS ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871121661",
"telephone_number": "505-357-4853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2428 MORRIS ST NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871121661",
"telephone_number": "505-357-4853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "ADRIAN",
"middle_name": "FERNANDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": "NM",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106S00000X",
"state": "NM"
}
],
"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 Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.