Active NPI
Jennifer Davis, LCSW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1962716795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-08551
- Practice address
- 2600 Yale Blvd SE
Albuquerque, NM 87106-4383 - Phone
- (505) 994-0000
- NPI assigned
- Aug 4, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 06987 | NM | |
| Clinical Social Worker | 1041C0700X | C-08551 | NM | Primary |
Addresses
Primary practice location
2600 Yale Blvd SE
Albuquerque, NM 87106-4383
Mailing address
1817 Carlisle Blvd NE
Albuquerque, NM 87110-4905
Phone (505) 842-9911
Other practice location 1
1817 Carlisle Blvd NE
Albuquerque, NM 87110-4905
Phone (505) 842-9911
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06987 | NM | MD | Clinical Social Worker |
| C-08551 | NM | MD | Clinical Social Worker |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1437814670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1962716795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1817 CARLISLE BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871104905",
"telephone_number": "505-842-9911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 YALE BLVD SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064383",
"telephone_number": "505-994-0000"
}
],
"practiceLocations": [
{
"address_1": "1817 Carlisle Blvd NE",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871104905",
"country_code": "US",
"telephone_number": "505-842-9911",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-04",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "06987",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-08551",
"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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.