Individual provider Active NPI

Kenneth W Hodder, LISW

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1912950999
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I-2148 Issued in NM
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
105879OtherNMMHN
860663612 0001OtherNMCIGNA HEALTHCARE
86066361287114A001OtherNMTRIWEST HEALTHCARE ALLIAN
NM10005MedicaidNM
00NM00R32LOtherNMBLUE 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
I-2148NMMDSocial 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

Verify at the official NPI Registry.