Individual provider Active NPI

Robert E. Kristy, MSW, MA

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1689007627
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
X-08307 Issued in NM
Practice address
1532 Cerrillos Rd
Building B
Santa Fe, NM 87505-3512
Phone
(505) 944-1364
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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 X-08307 NM Primary

Addresses

Primary practice location

1532 Cerrillos Rd
Building B
Santa Fe, NM 87505-3512

Mailing address

2415 San Patricio PLZ
Santa Fe, NM 87505-5834
Phone (240) 463-2104

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
X-08307NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1689007627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 SAN PATRICIO PLZ",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055834",
            "telephone_number": "240-463-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 CERRILLOS RD",
            "address_2": "BUILDING B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053512",
            "telephone_number": "505-944-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTY",
        "first_name": "ROBERT",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "MSW, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X-08307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.