Mark Dominic Lopez, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

63927 Issued in NM

Practice address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153

Phone

(505) 265-1711

NPI assigned

Jun 28, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651968000000",
    "number": "1013587401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5724 STRAND LOOP SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871069606",
            "telephone_number": "505-681-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SAN PEDRO DR SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085153",
            "telephone_number": "505-265-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARK",
        "middle_name": "DOMINIC",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2022-05-08",
        "certification_date": "2022-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "63927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Lopez, PT
• Lucille D. Lopez, LISW
• Mandy Lopez, LCSW
• Margaux Lopez
• Mark Lopez
• Matthew Lopez
• Melissa Lopez
• Melissa Lea Lopez, M.S., CCC-SLP
• Melynda Lopez, CNM
• Miguel Lopez, PHARMD

• Acute Care Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Acute Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2022; 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.