Individual provider Active NPI

Alexandra Lopez

  • Speech-Language Pathologist
  • Fishers, IN
National Provider Identifier
1396198644
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3920269912 Issued in IN
Practice address
9957 Allisonville Rd
Fishers, IN 46038-2006
Phone
(317) 841-7005
Fax
(317) 841-7029
NPI assigned
Jul 21, 2016
Last updated
Mar 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3920269912 IN Primary

Addresses

Primary practice location

9957 Allisonville Rd
Fishers, IN 46038-2006

Mailing address

9957 Allisonville Rd
Fishers, IN 46038-2006
Phone (317) 841-7005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170313000749 IN Practitioner - Qualified Speech Language Pathologist 3274817242 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3920269912INMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jun 1, 2023 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Feb 11, 2024 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Mar 28, 2025 Accepting new patients
Select Rehabilitation, LLC Speech-Language Pathologist CurrentSince May 30, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Speech-Language Pathologist CurrentSince Mar 28, 2025 Accepting new patients
Powerback Rehabilitation LLC Speech-Language Pathologist CurrentSince Feb 11, 2024 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jun 1, 2023 Accepting new patients

Locations

11570 E 126th St
Fishers, IN 46037
Phone (317) 349-5913

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

3630 Hickory Rd
Mishawaka, IN 46545
Phone (574) 252-7225

10 S 9th St
Ste 4
Noblesville, IN 46060

475 N Niles Ave
South Bend, IN 46617
Phone (574) 246-4123

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

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, 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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1396198644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9957 ALLISONVILLE RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382006",
            "telephone_number": "317-841-7005",
            "fax_number": "317-841-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9957 ALLISONVILLE RD",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382006",
            "telephone_number": "317-841-7005",
            "fax_number": "317-841-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "3920269912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.