Active NPI
Amanda Mae Lopez
- Contractor
- Rio Rico, AZ
National Provider Identifier
1043874464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 8629369
- Practice address
- 336 Ambrosia CT
Rio Rico, AZ 85648-2909 - Phone
- (520) 721-1887
- Fax
- (520) 407-5398
- NPI assigned
- May 1, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 8629369 | AZ | Primary |
Addresses
Primary practice location
336 Ambrosia CT
Rio Rico, AZ 85648-2909
Mailing address
PO Box 86537
Tucson, AZ 85754-6537
Phone (520) 721-1887
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8629369 | Other | AZ | THERAPEUTIC FOSTER CARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8629369 | AZ | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1043874464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86537",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857546537",
"telephone_number": "520-721-1887",
"fax_number": "520-372-7126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 AMBROSIA CT",
"city": "RIO RICO",
"state": "AZ",
"postal_code": "856482909",
"telephone_number": "520-721-1887",
"fax_number": "520-407-5398"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "AMANDA",
"middle_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-01",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AZ",
"license": "8629369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THERAPEUTIC FOSTER CARE",
"identifier": "8629369",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rio Rico, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.