Individual provider Active NPI

Roman Gurrola, BA

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1912411075
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2301 Yale Blvd SE BLDG F
Albuquerque, NM 87106-4228
Phone
(505) 272-7033
NPI assigned
Nov 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NM
Social Worker 104100000X Primary

Addresses

Primary practice location

2301 Yale Blvd SE BLDG F
Albuquerque, NM 87106-4228

Mailing address

2301 Yale Blvd SE BLDG F
Albuquerque, NM 87106-4228
Phone (505) 272-7033

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
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1912411075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 YALE BLVD SE BLDG F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064228",
            "telephone_number": "505-272-7033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 YALE BLVD SE BLDG F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064228",
            "telephone_number": "505-272-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURROLA",
        "first_name": "ROMAN",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-28",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "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 Oct 29, 2021; 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.