Active NPI
Jerry Woodle
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1962018697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 702 Broadway Blvd SE
Albuquerque, NM 87102-4285 - Phone
- (505) 394-8412
- NPI assigned
- Sep 17, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
702 Broadway Blvd SE
Albuquerque, NM 87102-4285
Mailing address
819 Forrester NE
Apt B
Albuquerque, NM 87102
Phone (505) 394-8412
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1962018697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "819 FORRESTER NE",
"address_2": "APT B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87102",
"telephone_number": "505-394-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 BROADWAY BLVD SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871024285",
"telephone_number": "505-394-8412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODLE",
"first_name": "JERRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-17",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"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 Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.