Active NPI
Carla J Lopez, FNP
- Family Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1205895794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP1340
- Practice address
- 5090 N 40TH St
Ste 250
Phoenix, AZ 85018-2111 - Phone
- (602) 258-3354
- Fax
- (602) 258-3368
- NPI assigned
- Mar 22, 2006
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP1340 | AZ | Primary |
Addresses
Primary practice location
5090 N 40TH St
Ste 250
Phoenix, AZ 85018-2111
Mailing address
5090 N 40TH St
Ste 250
Phoenix, AZ 85018-2111
Phone (602) 258-3354
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 626426 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP1340 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Partners Integrated Healthcare Inc. | Past | Accepting new patients | |
| Carondelet Medical Group Inc | Past | Accepting new patients | |
| Old Pueblo Healthcare LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Foot & Ankle Surgery Podiatrist
- Tucson, AZ
- NPI 1972834984
-
- Multi-Specialty Clinic/Center
- Tucson, AZ
- NPI 1558020503
-
- Nurse Practitioner
- Tucson, AZ
- NPI 1306890793
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350950400000",
"number": "1205895794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5090 N 40TH ST",
"address_2": "STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182111",
"telephone_number": "602-258-3354",
"fax_number": "602-258-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5090 N 40TH ST",
"address_2": "STE 250",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850182111",
"telephone_number": "602-258-3354",
"fax_number": "602-258-3368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "CARLA",
"middle_name": "J",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2012-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "AP1340",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "626426",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.