Individual provider Active NPI

Edward M Lopez, MD

  • Surgery Physician
  • Pueblo, CO
National Provider Identifier
1376512665
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
26672 Issued in CO
Practice address
1925 E Orman Ave
Suite A235
Pueblo, CO 81004-3537
Phone
(719) 557-3616
Fax
(719) 557-3690
NPI assigned
Mar 17, 2006
Last updated
Oct 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26672 CO Primary

Addresses

Primary practice location

1925 E Orman Ave
Suite A235
Pueblo, CO 81004-3537

Mailing address

1000 Lincoln St
Suite 208
Fort Morgan, CO 80701-3290
Phone (970) 542-4371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26672COMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Plains Physician Practices LLC CurrentSince Aug 31, 2009 Accepting new patients

Locations

1000 Lincoln St
Ste 208
Fort Morgan, CO 80701
Phone (970) 542-4371

220 E Beaver Ave
Fort Morgan, CO 80701
Phone (970) 458-5216

232 W Main St
Sterling, CO 80751
Phone (970) 522-3215

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1376512665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LINCOLN ST",
            "address_2": "SUITE 208",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013290",
            "telephone_number": "970-542-4371",
            "fax_number": "970-542-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 E ORMAN AVE",
            "address_2": "SUITE A235",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043537",
            "telephone_number": "719-557-3616",
            "fax_number": "719-557-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "EDWARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "26672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.