Rudy J Lopez, SO-IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

NEC HM8403 Issued in NC

Practice address

Joint Special Operations Medical Ctr
Usajfkswcs Stop a., 3004 Ardennes St.
Fort Bragg, NC 28310-9610

Phone

(910) 369-7775

NPI assigned

Apr 18, 2012

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1114284809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "JOINT SPECIAL OPERATIONS MEDICAL CTR",
            "address_2": "USAJFKSWCS STOP A., 3004 ARDENNES ST.",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283109610",
            "telephone_number": "910-369-7775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JOINT SPECIAL OPERATIONS MEDICAL CTR",
            "address_2": "USAJFKSWCS STOP A., 3004 ARDENNES ST.",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283109610",
            "telephone_number": "910-369-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "RUDY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "SO-IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "NC",
            "license": "NEC HM8403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby J Long, M.D.
• Thomas Joseph Longo, PSY.D.
• McKenzie Rose Look, ATC
• Todd Looney, MD
• Paola Lopez-Rosado, MD
• Gary Wayne Louden, PA-C
• Kanisha Love, MSW, LCSW, LCAS-A
• Jillian Luba
• Katie Campbell Lucas, RN
• Nathan Robert Lund, DDS

• Independent Duty Corpsman in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.