Individual provider Active NPI

Amanda Krystal Lopez, DC

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1417488495
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2154 Issued in NM
Practice address
7007 Wyoming Blvd NE Ste A3
Albuquerque, NM 87109-6941
Phone
(505) 822-5001
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2154 NM Primary

Addresses

Primary practice location

7007 Wyoming Blvd NE Ste A3
Albuquerque, NM 87109-6941

Mailing address

7007 Wyoming Blvd NE Ste A3
Albuquerque, NM 87109-6941
Phone (505) 822-5001

Other practice location 1

6001 Winter Haven Dr NW Ste H
Albuquerque, NM 87120-1746
Phone (505) 724-9000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171227002722 NM Practitioner - Chiropractic 8123386984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Active Chiropractic Spine and Joint Center LLCGroup PAC ID 0648400101, 3 clinicians

Practice addresses (Care Compare)

7528 4TH St NW
Suite D
Los Ranchos, NM 87107-6683
Phone (505) 822-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2154NMMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Therapy Inc. CurrentSince Dec 1, 2019 Accepting new patients
Active Chiropractic Spine & Joint Center, LLC Chiropractor CurrentSince Dec 6, 2019 Accepting new patients
Embodied Soul Chiropractic Chiropractor PastSince Dec 6, 2019 Accepting new patients

Locations

5305 Heritage Ct NE
Albuquerque, NM 87109
Phone (505) 699-4594

7007 Wyoming Blvd NE
Ste A3
Albuquerque, NM 87109
Phone (505) 699-4594

7528 4th St NW
Ste D
Los Ranchos, NM 87107
Phone (505) 822-5001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1417488495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE A3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096941",
            "telephone_number": "505-822-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE A3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871096941",
            "telephone_number": "505-822-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6001 Winter Haven Dr NW Ste H",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871201746",
            "country_code": "US",
            "telephone_number": "505-724-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "AMANDA",
        "middle_name": "KRYSTAL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.