Individual provider Active NPI

Terry Thayer, LISW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1376779223
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-05820 Issued in NM
Practice address
1224 Maple Meadows Dr NE
Rio Rancho, NM 87144-2557
Phone
(505) 917-4249
NPI assigned
Jun 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-05820 NM Primary

Addresses

Primary practice location

1224 Maple Meadows Dr NE
Rio Rancho, NM 87144-2557

Mailing address

1224 Maple Meadows Dr NE
Rio Rancho, NM 87144-2557
Phone (505) 917-4249

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

LicenseStateTypeSpecialty
I-05820NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1376779223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 MAPLE MEADOWS DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442557",
            "telephone_number": "505-917-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 MAPLE MEADOWS DR NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442557",
            "telephone_number": "505-917-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAYER",
        "first_name": "TERRY",
        "name_prefix": "Miss",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2009; 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.