Active NPI
Jordan Peterson
- School Social Worker
- Albuquerque, NM
National Provider Identifier
1508560624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- SWB-2022-0751
- Practice address
- 524 Central Ave SW
Albuquerque, NM 87102-3124 - Phone
- (505) 243-3308
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | SWB-2022-0751 | NM | Primary |
Addresses
Primary practice location
524 Central Ave SW
Albuquerque, NM 87102-3124
Mailing address
524 Central Ave SW
Albuquerque, NM 87102-3124
Phone (505) 243-3308
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 |
|---|---|---|---|
| SWB-2022-0751 | NM | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1508560624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 CENTRAL AVE SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023124",
"telephone_number": "505-243-3308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "524 CENTRAL AVE SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023124",
"telephone_number": "505-243-3308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2023-03-30",
"certification_date": "2023-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NM",
"license": "SWB-2022-0751",
"primary": true
}
],
"identifiers": [],
"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 Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.