Individual provider Active NPI

Rafael Lopez, D.C.

  • Chiropractor
  • Georgetown, TX
National Provider Identifier
1306559497
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
15346 Issued in TX
Practice address
101 Cooperative Way Ste 235
Georgetown, TX 78626-8211
Phone
(512) 630-0060
NPI assigned
Jan 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 15346 TX Primary

Addresses

Primary practice location

101 Cooperative Way Ste 235
Georgetown, TX 78626-8211

Mailing address

5833 Casstello Dr
Round Rock, TX 78665-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230403000720 TX Practitioner - Chiropractic 4385019462 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15346TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Georgetown Integrated Medical PLLC Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

101 Cooperative Way
Ste 235
Georgetown, TX 78626
Phone (512) 630-0060

2201 Double Creek Dr
Ste 4001
Round Rock, TX 78664
Phone (512) 630-0060

1602 W Avenue A
Temple, TX 76504
Phone (254) 778-6474

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": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1306559497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 CASSTELLO DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786653210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COOPERATIVE WAY STE 235",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786268211",
            "telephone_number": "512-630-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "RAFAEL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "15346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.