Active NPI
Michelle Antoinette Bruce, LMSW
- Social Worker
- Fort Sumner, NM
National Provider Identifier
1356656466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- X07076
- Practice address
- 546 N. 10TH St
Fort Sumner, NM 88119-0349 - Phone
- (575) 355-2414
- Fax
- (575) 355-7894
- NPI assigned
- Aug 12, 2010
- Last updated
- Aug 8, 2011
- 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 | X07076 | NM | Primary |
Addresses
Primary practice location
546 N. 10TH St
Fort Sumner, NM 88119-0349
Mailing address
PO Box 349
Fort Sumner, NM 88119-0349
Phone (575) 355-2414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S7012 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 37431
Albuquerque, NM 87176
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X07076 | NM | MD | Social Worker |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312761600000",
"number": "1356656466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 349",
"city": "FORT SUMNER",
"state": "NM",
"postal_code": "881190349",
"telephone_number": "575-355-2414",
"fax_number": "575-355-7894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "546 N. 10TH ST",
"city": "FORT SUMNER",
"state": "NM",
"postal_code": "881190349",
"telephone_number": "575-355-2414",
"fax_number": "575-355-7894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUCE",
"first_name": "MICHELLE",
"middle_name": "ANTOINETTE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-12",
"last_updated": "2011-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "X07076",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S7012",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Sumner, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.