Individual provider Active NPI

Samuel A Aragon

  • School Social Worker
  • Mora, NM
National Provider Identifier
1962690826
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
I-0865 Issued in NM
Practice address
Hwy 518 Ranger Rd.
Mora, NM 87773
Phone
(505) 387-3113
NPI assigned
Oct 4, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X I-0865 NM Primary

Addresses

Primary practice location

Hwy 518 Ranger Rd.
Mora, NM 87773

Mailing address

Hwy 518 Ranger Rd.
Mora, NM 87773
Phone (505) 387-3113

Other identifiers 1

IdentifierTypeStateIssuer
15700763MedicaidNM

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

State licenses

LicenseStateTypeSpecialty
I-0865NMMDSchool Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1962690826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HWY 518 RANGER RD.",
            "city": "MORA",
            "state": "NM",
            "postal_code": "87773",
            "telephone_number": "505-387-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 518 RANGER RD.",
            "city": "MORA",
            "state": "NM",
            "postal_code": "87773",
            "telephone_number": "505-387-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARAGON",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NM",
            "license": "I-0865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15700763",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mora, NM

Sources for this page

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