Active NPI
Marilu Lopez Nazareno, M.D.
- Family Medicine Physician
- Gaffney, SC
National Provider Identifier
1467423558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 19992
- Practice address
- 840 W Floyd Baker Blvd
Gaffney, SC 29341-1845 - Phone
- (864) 489-3300
- Fax
- (864) 488-3744
- NPI assigned
- Jan 27, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19992 | SC | Primary |
Addresses
Primary practice location
840 W Floyd Baker Blvd
Gaffney, SC 29341-1845
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 87631 | Other | SC | MEDCOST |
| T40630 | Medicaid | SC | |
| 01-82998 | Other | SC | UNITED HEALTHCARE |
| 89063TV | Medicaid | NC | |
| SCA009J577 | Other | SC | MEDICARE PIN |
| 5147604 | Other | SC | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19992 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1467423558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 743070",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303743070",
"telephone_number": "864-560-4304",
"fax_number": "864-650-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 W FLOYD BAKER BLVD",
"city": "GAFFNEY",
"state": "SC",
"postal_code": "293411845",
"telephone_number": "864-489-3300",
"fax_number": "864-488-3744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAZARENO",
"first_name": "MARILU",
"middle_name": "LOPEZ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-27",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "19992",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "87631",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "T40630",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "01-82998",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89063TV",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SCA009J577",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5147604",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaffney, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.