AMANDA WAGENBLAST (NPI# 1861046609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861046609 |
| Entity Type | Individual |
| Full Name | AMANDA WAGENBLAST |
| Practice Address |
1025 Hermosa Dr Se Albuquerque NM 87108-4312 |
| Practice Telephone | 5052370061 |
| Practice Fax Number | 5052370068 |
| Mailing Telephone | 5052370061 |
| Mailing Fax Number | 5052370068 |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2019-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | NM | Other Service Providers |
| Street Address |
1025 HERMOSA DR SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108-4312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104990845 | Michele Coleman | Psychologist | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2006-11-17 |
| 1366051880 | Paul Eric Bugyi | Social Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2020-07-30 |
| 1760090906 | Marcos Elvires Castellano | Social Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2020-07-14 |
| 1053929265 | Chelsea Diane Nichols | Social Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2020-07-14 |
| 1396380176 | Jennifer Jean Rex Mcnair | Counselor | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-11-15 |
| 1629613229 | Caren Ann Waters | Social Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-11-07 |
| 1285288027 | Michael T Gorham | Community Health Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-07-30 |
| 1598319352 | George Andrew Jones IIi | Community Health Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-07-30 |
| 1780141291 | Courtney Katherine Howe | Counselor | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-02-21 |
| 1710451885 | Philip Casady | Social Worker | 1025 Hermosa Dr Se, Albuquerque, NM 87108-4312 | 2019-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346847985 | Selinda Turner | Case Manager/Care Coordinator | 3620 Wyoming Blvd Ne Ste 102d, Albuquerque, NM 87111-3286 | 2020-10-06 |
| 1205452943 | Channda Bernadette Mitchell | Case Manager/Care Coordinator | 2301 Yale Blvd Se Ste F, Albuquerque, NM 87106-4228 | 2020-06-18 |
| 1346882909 | Jaineen Burkettsims | Case Manager/Care Coordinator | 11005 Spain Rd Ne Ste 22, Albuquerque, NM 87111-1871 | 2019-10-15 |
| 1285282715 | Aiden Charles Martinez | Case Manager/Care Coordinator | 6704 Nueva Pierda Street Nw, Albuquerque, NM 87120 | 2019-08-28 |
| 1023662947 | Tracy Lynn Nichols | Case Manager/Care Coordinator | 2329 Griffin Rd Sw, Albuquerque, NM 87105-7026 | 2019-07-29 |
| 1629632930 | Kassandra Lucero | Case Manager/Care Coordinator | 4118 Central Ave Se, Albuquerque, NM 87108-1177 | 2019-04-23 |
| 1740708809 | 11.11, LLC | Case Manager/Care Coordinator | 11724 Copper Pl Ne, Albuquerque, NM 87123 | 2017-09-08 |
| 1811411135 | Annette Romero | Case Manager/Care Coordinator | 9741 Candelaria, Albuquerque, NM 87112 | 2017-07-28 |
| 1245769512 | Danielle White | Case Manager/Care Coordinator | 801 Encino Pl Ne Ste E1, Albuquerque, NM 87102-2645 | 2017-06-08 |
| 1447784079 | Jess Fulton | Case Manager/Care Coordinator | 720 Vassar Dr Ne, Albuquerque, NM 87106-2724 | 2017-04-20 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
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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.