Jorge Luis Lopez, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1650 Cochrane Cir
Attn Credentials Office
Fort Carson, CO 80913-4603

Phone

(719) 526-7844

Fax

(719) 526-7984

NPI assigned

Feb 26, 2007

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104952209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL (EACH) USA MEDDAC",
            "address_2": "1650 COCHRANE CIRCLE, ATTN CREDENTIALS OFFICE",
            "city": "COLORADO SPINGS",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "ATTN CREDENTIALS OFFICE",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-7844",
            "fax_number": "719-526-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patty Jean Linville, MA
• Yue Liu
• Kaleigh Marie Lombardo, DMD
• Gregory Aaron Loomis, PT
• Mitchell Lopacki, DO
• Jacob Losse, PT
• Desirae Adella Lovato
• John Michael Lowery, M.D.
• Anthony Michael Lucca, PA-C
• Dana Marie Luntsford, DA

• Physician Assistant in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.