Individual provider Active NPI

Josie Lopez, M.D.

  • Family Medicine Physician
  • Glen Rose, TX
National Provider Identifier
1225264997
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R7807 Issued in TX
Practice address
409 Glenwood St Ste 500
Glen Rose, TX 76043
Phone
(254) 897-2202
Fax
(844) 659-3800
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125056143 IL
Family Medicine Physician 207Q00000X R7807 TX Primary

Addresses

Primary practice location

409 Glenwood St Ste 500
Glen Rose, TX 76043

Mailing address

409 Glenwood St Ste 500
Glen Rose, TX 76043-4933
Phone (254) 897-2202

Other identifiers 1

IdentifierTypeStateIssuer
386622001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180803000659 TX Practitioner - Family Practice 3971755885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glen Rose Healthcare, IncGroup PAC ID 6709986656, 12 clinicians

Practice addresses (Care Compare)

409 Glenwood St
Suite 500
Glen Rose, TX 76043-4933
Phone (254) 897-2202

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125056143ILMDFamily Medicine Physician
R7807TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Rose Healthcare, Inc Family Medicine CurrentSince Aug 1, 2018 Accepting new patients
Somervell County Hospital District Current Accepting new patients

Locations

409 Glenwood St
Ste 500
Glen Rose, TX 76043
Phone (254) 897-2202

409 Glenwood St
#500
Glen Rose, TX 76043
Phone (254) 897-1471

1021 Holden St
Glen Rose, TX 76043
Phone (254) 897-1425

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1948/brand/1/csg/1/fhir/r4
  • Direct secure messaging: josielopez@grmf.medalliesdirect.net
  • Direct secure messaging: josie.lopez.1@1948.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1244419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549497600000",
    "number": "1225264997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 GLENWOOD ST STE 500",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "760434933",
            "telephone_number": "254-897-2202",
            "fax_number": "254-897-1638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 GLENWOOD ST STE 500",
            "city": "GLEN ROSE",
            "state": "TX",
            "postal_code": "76043",
            "telephone_number": "254-897-2202",
            "fax_number": "844-659-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-08",
        "last_updated": "2019-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125056143",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R7807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "386622001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rose, TX

Sources for this page

Verify at the official NPI Registry.