Active NPI
Robert Irvin
- Clinical Social Worker
- Socorro, NM
National Provider Identifier
1700283892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- M-07614
- Practice address
- 1200 Highway 60
Socorro, NM 87801-3914 - Phone
- (575) 835-2444
- NPI assigned
- Dec 4, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | M-07614 | NM | Primary |
Addresses
Primary practice location
1200 Highway 60
Socorro, NM 87801-3914
Mailing address
1200 Highway 60
Socorro, NM 87801-3914
Phone (505) 327-4796
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 |
|---|---|---|---|
| M-07614 | NM | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418947200000",
"number": "1700283892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 HIGHWAY 60",
"city": "SOCORRO",
"state": "NM",
"postal_code": "878013914",
"telephone_number": "505-327-4796",
"fax_number": "505-325-9133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 HIGHWAY 60",
"city": "SOCORRO",
"state": "NM",
"postal_code": "878013914",
"telephone_number": "575-835-2444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRVIN",
"first_name": "ROBERT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-04",
"last_updated": "2014-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "M-07614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Socorro, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.