Active NPI
Carmen Ferreira-Lopez, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Southlake, TX
National Provider Identifier
1205681525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1157486
- Practice address
- 620 N Kimball Ave Ste 110
Southlake, TX 76092-6856 - Phone
- (469) 777-4691
- NPI assigned
- Apr 19, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1157486 | TX | Primary |
Addresses
Primary practice location
620 N Kimball Ave Ste 110
Southlake, TX 76092-6856
Mailing address
1050 Oak Knoll Dr
Burleson, TX 76028-8370
Phone (817) 936-8080
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1157486 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Psychiatry PA | Psychiatric/Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713830400000",
"number": "1205681525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 OAK KNOLL DR",
"city": "BURLESON",
"state": "TX",
"postal_code": "760288370",
"telephone_number": "817-936-8080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N KIMBALL AVE STE 110",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926856",
"telephone_number": "469-777-4691"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERREIRA-LOPEZ",
"first_name": "CARMEN",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-19",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "TX",
"license": "1157486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.