Active NPI
Kate Danielle Lopez, NP
- Pediatric Nurse Practitioner
- Jacksonville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 5017212
- Practice address
- 120 Memorial Dr
Jacksonville, NC 28546-6328 - Phone
- (910) 353-0581
- Fax
- (910) 577-1150
- NPI assigned
- Nov 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 5017212 | NC | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | 383284 | NY |
Addresses
Primary practice location
120 Memorial Dr
Jacksonville, NC 28546-6328
Mailing address
PO Box 986513
Dept 100
Boston, MA 02298-6513
Phone (910) 219-8326
Other practice location 1
118 Memorial Dr
Jacksonville, NC 28546-6328
Phone (910) 353-0581
Other names 1
- Kate Danielle Dumain
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5017212 | NC | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| Amm Healthcare, PA | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients | |
| Jacksonville Behavior and Mental Health | Current | Accepting new patients | |
| Jacksonville Children'S and Multispecialty Clinic, PA | Current | Accepting new patients | |
| Family Care Clinic, P.a. | Past | Accepting new patients |
Locations
114C Memorial Dr
Jacksonville, NC 28546
Phone (910) 346-3976
118 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581
120 Memorial Dr
Jacksonville, NC 28546
Phone (910) 353-0581
111 E 210th St
Bronx, NY 10467
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Jacksonville, NC
- NPI 1164519070
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Family Medicine Physician
- Cary, NC
- NPI 1528639689
-
- Adolescent and Children Mental Health Clinic/Center
- Jacksonville, NC
- NPI 1770771750
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- Clinic/Center
- Jacksonville, NC
- NPI 1316033590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1407511595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 986513",
"address_2": "DEPT 100",
"city": "BOSTON",
"state": "MA",
"postal_code": "022986513",
"telephone_number": "910-219-8326",
"fax_number": "910-939-4269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 MEMORIAL DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285466328",
"telephone_number": "910-353-0581",
"fax_number": "910-577-1150"
}
],
"practiceLocations": [
{
"address_1": "118 Memorial Dr",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "NC",
"postal_code": "285466328",
"country_code": "US",
"telephone_number": "910-353-0581",
"fax_number": "910-353-1351",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOPEZ",
"first_name": "KATE",
"middle_name": "DANIELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-03",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NC",
"license": "5017212",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "383284",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATE",
"last_name": "DUMAIN",
"middle_name": "DANIELLE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.