Individual provider Active NPI

Angelica Raye Lopez, DNP, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1366135378
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
303772 Issued in AZ
Practice address
9520 W Palm LN Ste 150
Phoenix, AZ 85037-4454
Phone
(602) 584-5444
Fax
(602) 584-6202
NPI assigned
May 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 303772 AZ Primary

Addresses

Primary practice location

9520 W Palm LN Ste 150
Phoenix, AZ 85037-4454

Mailing address

9520 W Palm LN Ste 150
Phoenix, AZ 85037-4454
Phone (602) 584-5444

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

LicenseStateTypeSpecialty
303772AZMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1366135378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9520 W PALM LN STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374454",
            "telephone_number": "602-584-5444",
            "fax_number": "602-584-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 W PALM LN STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850374454",
            "telephone_number": "602-584-5444",
            "fax_number": "602-584-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ANGELICA",
        "middle_name": "RAYE",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-26",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "303772",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 11, 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.

Verify at the official NPI Registry.