William Anthony Burrola, CPSW

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

890 Issued in NM

Practice address

2105 Hassler Valley Rd
Gallup, NM 87301

Phone

(505) 413-3447

NPI assigned

Feb 2, 2021

Last updated

Feb 2, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Santa Fe Recovery Center Inc

  • Substance Abuse Rehabilitation Facility
  • Gallup, NM
  • NPI 1033716972
  NPD

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1326639378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BLUEGILL DR",
            "city": "THOREAU",
            "state": "NM",
            "postal_code": "873234002",
            "telephone_number": "505-728-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HASSLER VALLEY RD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-413-3447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROLA",
        "first_name": "WILLIAM",
        "middle_name": "ANTHONY",
        "credential": "CPSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NM",
            "license": "890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Daniel Burgner
• Alicia C Burke, PHARM.D.
• Delina J. Burke, MPH, CNM
• Nicole Keyoko Burke, RN
• Brittnei Burns, RN BSN
• Julie R Bussewitz, O.T.
• Alice Bybee
• Kristopher Charles Byman, RN
• Flor J. Caballar Gonzaga, MD
• Marlon Caballero, RN, BSN

• Peer Specialist in Gallup, NM
• Providers in Gallup, NM by specialty
• Peer Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.