Individual provider Active NPI

Lino Lopez Jr., NP-C

  • Nurse Practitioner
  • Corpus Christi, TX
National Provider Identifier
1104405653
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1031692 Issued in TX
Practice address
4444 Corona Dr Ste 131
Corpus Christi, TX 78411-4321
Phone
(361) 645-7999
NPI assigned
Apr 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1031692 TX Primary

Addresses

Primary practice location

4444 Corona Dr Ste 131
Corpus Christi, TX 78411-4321

Mailing address

2044 S Clack St Apt 544
Abilene, TX 79606-1395
Phone (361) 687-5108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230622000335 TX Practitioner - Nurse Practitioner 2062870157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. CurrentSince Jun 1, 2023 Accepting new patients
Greater Valley Hospice Alliance LP PastSince Apr 6, 2021 Accepting new patients

Locations

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

Interoperability endpoints

  • Direct secure messaging: lino.lopez@wellmed.eclinicaldirectplus.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1104405653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 S CLACK ST APT 544",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796061395",
            "telephone_number": "361-687-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 CORONA DR STE 131",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114321",
            "telephone_number": "361-645-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "LINO",
        "name_suffix": "Jr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1031692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.