Active NPI
Amy Catherine Mathis, LMSW
- Social Worker
- Albuquerque, NM
National Provider Identifier
1881804607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M-05376
- Practice address
- 2400 Louisiana Blvd NE
Albuquerque, NM 87110-4303 - Phone
- (505) 346-9431
- Fax
- (505) 346-9402
- NPI assigned
- May 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | M-05376 | NM | Primary |
Addresses
Primary practice location
2400 Louisiana Blvd NE
Albuquerque, NM 87110-4303
Mailing address
11232 Campo del Sol Ave NE
Albuquerque, NM 87123-1264
Phone (505) 291-0465
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-05376 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881804607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11232 CAMPO DEL SOL AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871231264",
"telephone_number": "505-291-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 LOUISIANA BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104303",
"telephone_number": "505-346-9431",
"fax_number": "505-346-9402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIS",
"first_name": "AMY",
"middle_name": "CATHERINE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "M-05376",
"primary": true
}
],
"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 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.