Active NPI
Anne Susan Wagoner-Ford, MSW, LISW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1689962227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I-08810
- Practice address
- 2600 Yale Blvd SE
Albuquerque, NM 87106-4217 - Phone
- (505) 994-7999
- Fax
- (505) 994-7975
- NPI assigned
- Jul 18, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-08810 | NM | Primary |
| Clinical Social Worker | 1041C0700X | C008083 | NC |
Addresses
Primary practice location
2600 Yale Blvd SE
Albuquerque, NM 87106-4217
Mailing address
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C008083 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415318400000",
"number": "1689962227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064374",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 YALE BLVD SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064217",
"telephone_number": "505-994-7999",
"fax_number": "505-994-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER-FORD",
"first_name": "ANNE",
"middle_name": "SUSAN",
"credential": "MSW, LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-18",
"last_updated": "2014-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "I-08810",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C008083",
"primary": false
}
],
"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 Nov 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.