Active NPI
Kenneth W Hodder, LISW
- Social Worker
- Albuquerque, NM
National Provider Identifier
1912950999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- I-2148
- Practice address
- 1100 Alameda Blvd NW
Albuquerque, NM 87114-1937 - Phone
- (505) 897-7883
- Fax
- (505) 792-8578
- NPI assigned
- May 18, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | I-2148 | NM | Primary |
Addresses
Primary practice location
1100 Alameda Blvd NW
Albuquerque, NM 87114-1937
Mailing address
1100 Alameda Blvd NW
Albuquerque, NM 87114-1937
Phone (505) 897-7883
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105879 | Other | NM | MHN |
| 860663612 0001 | Other | NM | CIGNA HEALTHCARE |
| 86066361287114A001 | Other | NM | TRIWEST HEALTHCARE ALLIAN |
| NM10005 | Medicaid | NM | |
| 00NM00R32L | Other | NM | BLUE CROSS BLUE SHIELD |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060707000322 | NM | Practitioner - Clinical Social Worker | 5991717381 | Practice locations: Los Ranchos, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6430 Rio Grande Blvd NW
Los Ranchos, NM 87107-5631
Phone (505) 897-7883
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I-2148 | NM | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1912950999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 ALAMEDA BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871141937",
"telephone_number": "505-897-7883",
"fax_number": "505-792-8578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 ALAMEDA BLVD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871141937",
"telephone_number": "505-897-7883",
"fax_number": "505-792-8578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODDER",
"first_name": "KENNETH",
"middle_name": "W",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NM",
"license": "I-2148",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN",
"identifier": "105879",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "860663612 0001",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIWEST HEALTHCARE ALLIAN",
"identifier": "86066361287114A001",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NM10005",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00NM00R32L",
"state": "NM"
}
],
"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 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.