Ivan Ricardo Lopez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16852 Issued in FL

Practice address

11033 NW State Road 20
Bristol, FL 32321-6406

Phone

(850) 643-1155

NPI assigned

Mar 16, 2020

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivan.lopez@chcict.eclinicaldirectplus.com

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.

• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1952591851

  Clinical, CT

  Medicare reassignment Care Compare group NPD
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Groton, CT
  • NPI 1437334851
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Clinton, CT
  • NPI 1447435862
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
  • NPI 1457822934
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1518139500
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New London, CT
  • NPI 1548677982
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Enfield, CT
  • NPI 1679761027
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Meriden, CT
  • NPI 1720263148
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New Britain, CT
  • NPI 1912182338
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Norwalk, CT
  • NPI 1972788321
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Waterbury, CT
  • NPI 1972866556
  Care Compare group
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • New London, CT
  • NPI 1982889309
  Care Compare group

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

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1164058756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 LAKE FRONT DR APT B1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323037171",
            "telephone_number": "863-216-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11033 NW STATE ROAD 20",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323216406",
            "telephone_number": "850-643-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "IVAN",
        "middle_name": "RICARDO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "16852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liberty County School Board
• Liberty County School Board
• Liberty County Senior Citizens Assoc. Inc.
• Liberty Oaks Alf LLC
• Jateasia Ashley Littles, MSW
• Telisa D Marlowe-McCray
• Annabelle Jamie Martinez, RN
• Keisa Yvette McBride, MPH
• Autumn Grace McLemore, MSW
• Kimberly McMillan

• All providers in Bristol, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.