Staci E Lopez-Vergara, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP122615 Issued in TX

Practice address

9840 N Beach St
Fort Worth, TX 76244-6184

Phone

(817) 431-3898

Fax

(817) 379-1161

NPI assigned

Dec 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Staci Dickard Former name

Electronic endpoints 1

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdickard13372@cookchildrens.direct-ci.com

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.

• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Cook Children'S Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  NPD

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1407191323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-1855",
            "fax_number": "682-885-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9840 N BEACH ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446184",
            "telephone_number": "817-431-3898",
            "fax_number": "817-379-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-VERGARA",
        "first_name": "STACI",
        "middle_name": "E",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "755740",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP122615",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP122615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sdickard13372@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "9840 N Beach St",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762446184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACI",
            "last_name": "DICKARD",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katheryn Lopez Arjona, CBS
• Ibonne Lopez Maso
• Lopez Wellness, PLLC
• Omar Lopez-Flores, APRN
• Maria Cristina Lopez-Rosario, MD
• Angel Luis Lopez, DPM
• Cesar Lopez, HEALTH EDUCATOR
• Clarissa Marie Lopez, LCSW
• Courtney Lopez, OTR
• Cynthia Lopez

• Pediatric Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.