Active NPI
Shelby Bobelu, LMSW
- Social Worker
- Acoma, NM
National Provider Identifier
1508395278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- X-09679
- Practice address
- 45 Pinsbarri Dr.
Acoma, NM 87034 - Phone
- (505) 552-6661
- Fax
- (505) 552-6426
- NPI assigned
- Jun 7, 2017
- 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 | X-09679 | NM | Primary |
Addresses
Primary practice location
45 Pinsbarri Dr.
Acoma, NM 87034
Mailing address
PO Box 328
Acoma, NM 87034-0328
Phone (505) 552-6661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81488076 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X-09679 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Acoma | Past | Accepting new patients | |
| Pueblo of Acoma | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Pueblo of Acoma, NM
- NPI 1619323565
-
- Community/Behavioral Health Agency
- Acoma, NM
- NPI 1710343942
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496793600000",
"number": "1508395278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 328",
"city": "ACOMA",
"state": "NM",
"postal_code": "870340328",
"telephone_number": "505-552-6661",
"fax_number": "505-552-6426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 PINSBARRI DR.",
"city": "ACOMA",
"state": "NM",
"postal_code": "87034",
"telephone_number": "505-552-6661",
"fax_number": "505-552-6426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOBELU",
"first_name": "SHELBY",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-07",
"last_updated": "2017-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "X-09679",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "81488076",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Acoma, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.