Individual provider Active NPI

Mark Ovrick

  • Social Worker
  • Ruidoso, NM
National Provider Identifier
1871730879
Registry record updated Oct 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
18730 Issued in LA
Practice address
1204 Mechem Dr
Suite 11
Ruidoso, NM 88345-7213
Phone
(575) 258-4946
Fax
(575) 258-4949
NPI assigned
Jan 13, 2009
Last updated
Oct 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-05300 NM
Social Worker 104100000X 18730 LA Primary

Addresses

Primary practice location

1204 Mechem Dr
Suite 11
Ruidoso, NM 88345-7213

Mailing address

1204 Mechem Dr
Suite 11
Ruidoso, NM 88345-7213
Phone (575) 258-4946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100720001014 NM Practitioner - Clinical Social Worker 5991837361 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Center, Inc.Group PAC ID 6507858461, 6 clinicians

Practice addresses (Care Compare)

1900 10TH St
Alamogordo, NM 88310-5053
Phone 5754882500102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18730LAMDSocial Worker
I-05300NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center, Inc. CurrentSince Nov 8, 2021 Accepting new patients
Zia Community Cares, LLC Social Worker CurrentSince May 1, 2020 Accepting new patients
Southwest Cares NV LLC PastSince May 18, 2010 Accepting new patients
Center of Protective Environment, Inc. Past Accepting new patients

Locations

1900 10th St
Alamogordo, NM 88310
Phone (575) 437-7404

1610 San Pedro Dr NE
Albuquerque, NM 87110

5400 Gibson Blvd SE
Ste 11
Albuquerque, NM 87108
Phone (505) 832-7141

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728172800000",
    "number": "1871730879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MECHEM DR",
            "address_2": "SUITE 11",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457213",
            "telephone_number": "575-258-4946",
            "fax_number": "575-258-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MECHEM DR",
            "address_2": "SUITE 11",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883457213",
            "telephone_number": "575-258-4946",
            "fax_number": "575-258-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVRICK",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05300",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "18730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

Verify at the official NPI Registry.