Individual provider Active NPI

Cameron Harrell, MS

  • Community Health Worker
  • Santa Ana Pueblo, NM
National Provider Identifier
1558169391
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
G-1698 Issued in NM
Practice address
2 Dove Rd
Santa Ana Pueblo, NM 87004-5906
Phone
(408) 310-7166
NPI assigned
Mar 6, 2025
Last updated
Mar 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X G-1698 NM Primary

Addresses

Primary practice location

2 Dove Rd
Santa Ana Pueblo, NM 87004-5906

Mailing address

4825 Isleta Blvd SW
Albuquerque, NM 87105-6659
Phone (408) 310-7166

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
G-1698NMMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1558169391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 ISLETA BLVD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871056659",
            "telephone_number": "408-310-7166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DOVE RD",
            "city": "SANTA ANA PUEBLO",
            "state": "NM",
            "postal_code": "870045906",
            "telephone_number": "408-310-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "CAMERON",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": "G-1698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana Pueblo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.