Thomas J Kerley, LBSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

B-1192 Issued in NM

Practice address

1000 E Aztec Ave
Gallup, NM 87301-5509

Phone

(505) 721-1872

NPI assigned

Sep 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Gallup McKinley County Schools

  • Local Education Agency (LEA)
  • Gallup, NM
  • NPI 1730210113
  NPD (past)

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1942494836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015509",
            "telephone_number": "505-721-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015509",
            "telephone_number": "505-721-1872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERLEY",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "B-1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B-1192",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loretta Kendricks, CRNA
• Kendra Leigh Kennedy
• Loraine Miner Kennell, RN
• Maisha Kenyatta, RN
• Lauren Kerkemeyer, RN
• Lacy Kerr, RN
• Linda C. Kerth, PH.D., M.A.
• Boady Kervin
• Dale E Kester, M.D.
• Elizabeth Ann Ketner, M.H.S., MD

• School Social Worker in Gallup, NM
• Providers in Gallup, NM by specialty
• School Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.

Verify at the official NPI Registry.