Individual provider Active NPI

Kyle Lopez, DC

  • Chiropractor
  • Fairhope, AL
National Provider Identifier
1063485134
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1961 Issued in AL
Practice address
401 N Section St
Fairhope, AL 36532-2613
Phone
(251) 928-5058
Fax
(251) 928-5666
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1961 AL Primary

Addresses

Primary practice location

401 N Section St
Fairhope, AL 36532-2613

Mailing address

401 N Section St
Fairhope, AL 36532-2613
Phone (251) 928-5058

Other identifiers 3

IdentifierTypeStateIssuer
46674OtherALHEALTHSPRINGS OF ALABAMA
051096597OtherALBCBS
10911827OtherALAETNA/CAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131101001444 AL Practitioner - Chiropractic 0042445421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

401 N Section St
Fairhope, AL 36532-2613
Phone (251) 928-5058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1961ALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Regenerative Medicine of South Alabama LLC CurrentSince Apr 4, 2019 Accepting new patients
Kyle Lopez DC PC Chiropractor CurrentSince Jul 1, 2000 Accepting new patients

Locations

401 N Section St
Fairhope, AL 36532
Phone (251) 928-5058

3929 Airport Blvd
Ste 3-110
Mobile, AL 36609
Phone (251) 301-0875

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1063485134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N SECTION ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322613",
            "telephone_number": "251-928-5058",
            "fax_number": "251-928-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N SECTION ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365322613",
            "telephone_number": "251-928-5058",
            "fax_number": "251-928-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "KYLE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSPRINGS OF ALABAMA",
            "identifier": "46674",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051096597",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/CAQH",
            "identifier": "10911827",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.