Individual provider Active NPI

Daniel Lopez, MS, LAT, ATC

  • Athletic Trainer
  • Baltimore, MD
National Provider Identifier
1194718577
Registry record updated Apr 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A0000322 Issued in MD
Practice address
2425 Old Court Rd
Baltimore, MD 21208-3430
Phone
(410) 339-4179
Fax
(410) 339-7534
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A0000322 MD Primary

Addresses

Primary practice location

2425 Old Court Rd
Baltimore, MD 21208-3430

Mailing address

2425 Old Court Rd
Baltimore, MD 21208-3430
Phone (410) 339-4179

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A0000322MDMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523059200000",
    "number": "1194718577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 OLD COURT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212083430",
            "telephone_number": "410-339-4179",
            "fax_number": "410-339-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 OLD COURT RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212083430",
            "telephone_number": "410-339-4179",
            "fax_number": "410-339-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DANIEL",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2018-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2018; 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.