Tom James Kosbab, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M-04780 Issued in NM

Practice address

301 Loma Colorado St NE
Rio Rancho, NM 87124-6562

Phone

(505) 896-5897

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578619599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 AVENIDA MANANA NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871106169",
            "telephone_number": "505-265-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LOMA COLORADO ST NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871246562",
            "telephone_number": "505-896-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSBAB",
        "first_name": "TOM",
        "middle_name": "JAMES",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M-04780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53174216",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Social Worker in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.