MR. PHILLIP ADAM MORA JR. (NPI# 1639770639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639770639 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP ADAM MORA JR. |
| Credential | CPSW |
| Practice Address |
933 Bradbury Dr Se Ste 2222 Albuquerque NM 87106-4375 |
| Practice Telephone | 5055446265 |
| Mailing Telephone | 5055446265 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| Y | 175T00000X | Peer Specialist | 1077 | NM | Other Service Providers |
| N | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
933 BRADBURY DR SE STE 2222 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87106-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447252606 | Catherine Obojski | Nurse Anesthetist, Certified Registered | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2005-06-01 |
| 1699380642 | Sarah Heredia | Registered Nurse | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2020-09-15 |
| 1457969586 | Ugur Barut | Registered Nurse | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2020-07-15 |
| 1104451285 | Brianna Newberry | Case Manager/Care Coordinator | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2020-03-09 |
| 1639724255 | Ashton Mckinney | Nurse Practitioner | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2019-08-09 |
| 1154986040 | Theresa A Weidemann | Nurse Practitioner | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106 | 2019-05-06 |
| 1215439062 | Sarah Elizabeth Davis | Nurse Practitioner | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2018-03-07 |
| 1912438862 | Emily Ball | Emergency Medicine | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2017-03-22 |
| 1629420161 | Jennifer Gonzales | Social Worker | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2016-07-08 |
| 1386099646 | Miranda A Aragon | Family Medicine | 933 Bradbury Dr Se Ste 2222, Albuquerque, NM 87106-4375 | 2016-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679808 | Jorge Licano | Student in an Organized Health Care Education/Training Program | Unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-04 |
| 1730780032 | Joseph Sanchez | Student in an Organized Health Care Education/Training Program | (unmh Hospital 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2020-11-03 |
| 1336746205 | Evan Laub | Pharmacist | 2950 Central Ave. Sw, Albuquerque, NM 87106 | 2020-10-05 |
| 1487203154 | Theresa Martinez | Technician | 5680 Avedon Dr. Se, Albuquerque, NM 87106 | 2019-09-05 |
| 1205300647 | Louis Mayer II | Specialist/Technologist | 1414 University Blvd Tow Diehm Athletic Facility, Albuquerque, NM 87106 | 2019-01-18 |
| 1235633355 | Terrena Grace Vigil Brady | Occupational Therapist | 1001 Yale Blvd, Albuquerque, NM 87106 | 2018-03-22 |
| 1205355195 | Yaritza Ruiz | Specialist/Technologist | 1200 Avenida Cesar Chavez, 231d, Albuquerque, NM 87106 | 2017-09-12 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1295265882 | Hallie Chancellor | Behavior Technician | 1801 Gibson Blvd Se Apt 1046, Albuquerque, NM 87106 | 2017-06-15 |
| 1780111757 | Jiana Hook | Physical Medicine & Rehabilitation | 1414 University Blvd. Se, Albuquerque, NM 87106 | 2017-05-22 |
| Find all providers in zip 87106 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053882795 | Mateo R Duran | Peer Specialist | 10519 Trieste Ct Nw, Albuquerque, NM 87114-5187 | 2018-12-06 |
| 1891174140 | Osman Varela | Peer Specialist | 402 1/2 Harvard Dr Se, Albuquerque, NM 87106-3527 | 2015-05-20 |
| 1407456742 | Gabriela Gallegos | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-10-27 |
| 1306443148 | Andrea Michelle Vallejos | Peer Specialist | 805 Tijeras Ave Nw, Albuquerque, NM 87102-3099 | 2020-10-05 |
| 1033729652 | Stacy L Burleson | Peer Specialist | 3150 Carlisle Blvd Ne Ste 110, Albuquerque, NM 87110-1681 | 2020-08-07 |
| 1134738651 | Antonio N Johnson | Peer Specialist | 3301 Los Arboles Ave Ne, Albuquerque, NM 87107-1943 | 2020-07-30 |
| 1396363677 | Liliana Spurgeon | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-13 |
| 1801413026 | Christopher Padilla | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-07-03 |
| 1679196489 | Denise Lerouge | Peer Specialist | 9201 Montgomery Blvd Ne Bldg 5, Albuquerque, NM 87111-2468 | 2020-05-27 |
| 1942823125 | Dawn Green | Peer Specialist | 912 1st St Nw, Albuquerque, NM 87102-2355 | 2020-05-22 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87106 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.