Individual provider Active NPI

Rose Lopez, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Avondale, AZ
National Provider Identifier
1235975400
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
309644 Issued in AZ
Practice address
824 N 99TH Ave
Avondale, AZ 85323-5324
Phone
(602) 818-3980
NPI assigned
Jul 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 309644 AZ Primary

Addresses

Primary practice location

824 N 99TH Ave
Avondale, AZ 85323-5324

Mailing address

PO Box 552
Tolleson, AZ 85353-0552
Phone (602) 818-3980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121003664 AZ Practitioner - Nurse Practitioner 7315476389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Bridges Inc 106 clinicians

Practice addresses (Care Compare)

824 N 99TH Ave
Suite 109
Avondale, AZ 85323-5327
Phone (623) 907-1457

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309644AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Bridges, Inc. CurrentSince Nov 17, 2024 Accepting new patients
Community Bridges, Inc Current Accepting new patients
Community Bridges, Inc. CurrentSince Nov 17, 2024 Accepting new patients
Community Bridges, Inc. Current Accepting new patients
Community Bridges, Inc. PastSince Jul 21, 2024 Accepting new patients
Community Bridges, Inc. Past Accepting new patients

Locations

824 N 99th Ave
Ste 109
Avondale, AZ 85323
Phone (623) 907-1457

824 N 99th Ave
Ste 107108
Avondale, AZ 85323
Phone (623) 907-1457

675 E Cottonwood Ln
Ste 140
Casa Grande, AZ 85122
Phone (520) 426-0088

358 E Javelina Ave
Ste 101
Mesa, AZ 85210
Phone (480) 507-3180

554 S Bellview
Rm B
Mesa, AZ 85204
Phone (480) 649-1141

358 E Javelina Ave
Ste 102
Mesa, AZ 85210
Phone (480) 507-3180

460 N Mesa Dr
Ste 201
Mesa, AZ 85201
Phone (480) 838-5550

560 S Bellview
Rm B
Mesa, AZ 85204
Phone (480) 962-7711

1855 W Baseline Rd
Ste 101
Mesa, AZ 85202

560 S Bellview
Rm A
Mesa, AZ 85204
Phone (480) 962-7711

2770 E Van Buren St
Rm Abd
Phoenix, AZ 85008
Phone (602) 273-9999

2770 E Van Buren St
Ste Abd
Phoenix, AZ 85008

2770 E Van Buren St
Phoenix, AZ 85008
Phone (602) 273-9999

1520 E Pima St
Phoenix, AZ 85034
Phone (480) 232-8325

250 S Toole Ave
Ste 110
Tucson, AZ 85701
Phone (520) 323-1212

250 S Toole Ave
Ste A
Tucson, AZ 85701
Phone (520) 323-1312

2950 N Dodge Blvd
Tucson, AZ 85716
Phone (520) 327-9863

250 S Toole Ave
Ste B
Tucson, AZ 85701
Phone (520) 323-1312

3180 E 40th St
Yuma, AZ 85365
Phone (928) 341-0335

Interoperability endpoints

  • Direct secure messaging: rose.lopezbht.p1@direct.cbridges.nextgenshare.com

Organizations & group practices 7

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1235975400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853530552",
            "telephone_number": "602-818-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 N 99TH AVE",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853235324",
            "telephone_number": "602-818-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "309644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.