Organization Active NPI

Sovereignty Functional Medicine

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1124983747
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SOVEREIGNTY FUNCTIONAL MEDICINE
Practice address
3410 Stoney Byu
San Antonio, TX 78245-4057
Phone
(210) 416-2075
NPI assigned
Dec 16, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Alma Angelica Lozano Mercado, FNPNPI 1417573239
Title
Provider/Manager
Phone
(210) 416-2075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

3410 Stoney Byu
San Antonio, TX 78245-4057

Mailing address

2900 E Broadway Blvd Ste 100
Tucson, AZ 85716-5344
Phone (201) 416-2075

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1124983747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 E BROADWAY BLVD STE 100",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857165344",
            "telephone_number": "201-416-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 STONEY BYU",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782454057",
            "telephone_number": "210-416-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGNTY FUNCTIONAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "LOZANO MERCADO",
        "authorized_official_first_name": "ALMA",
        "authorized_official_middle_name": "ANGELICA",
        "authorized_official_title_or_position": "PROVIDER/MANAGER",
        "authorized_official_telephone_number": "210-416-2075",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.