Individual provider Active NPI

Brennan Williams

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1962635607
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
5601 Domingo Rd NE
Albuquerque, NM 87108-1610
Phone
(505) 268-5295
Fax
(505) 268-9967
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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 Primary

Addresses

Primary practice location

5601 Domingo Rd NE
Albuquerque, NM 87108-1610

Mailing address

1201 3Rd St NW
Albuquerque, NM 87102-1403
Phone (505) 268-5295

Other identifiers 1

IdentifierTypeStateIssuer
B9311MedicaidNM

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": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1962635607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 3RD ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021403",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DOMINGO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081610",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRENNAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B9311",
            "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 Oct 19, 2009; 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.