NPIMap

Individual provider Active NPI

Nicole Lopez, MD

  • Family Medicine Physician
  • Amarillo, TX
National Provider Identifier
1477587079
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L2431 Issued in TX
Practice address
1400 S Coulter St
Amarillo, TX 79106-1786
Phone
(806) 414-9559
Fax
(806) 351-3765
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L2431 TX Primary

Addresses

Primary practice location

1400 S Coulter St
Amarillo, TX 79106-1786

Mailing address

1400 Wallace Blvd
Amarillo, TX 79106-1708
Phone (806) 414-9559

Other identifiers 5

IdentifierTypeStateIssuer
151785608MedicaidTX
100848160AMedicaidOK
151785606MedicaidTX
151785607MedicaidTX
84426756MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050407000930 TX Practitioner - Family Practice 1850348178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center AmarilloGroup PAC ID 9234037847, 74 clinicians

Practice addresses (Care Compare)

1400 S Coulter St
Amarillo, TX 79106-1786

Hospital & facility affiliations

  • Bsa Compassion Home Care Home health agency, Amarillo, TX, CCN 677943
  • Excelacare Hospice Hospice, Lubbock, TX, CCN 671561
  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231
  • Northwest Texas Hospital Hospital, Amarillo, TX, CCN 450209

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L2431TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center CurrentSince Sep 1, 2017 Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Current Accepting new patients
Texas Tech University Health Sciences Center Amarillo Family Medicine CurrentSince Sep 1, 2017 Accepting new patients
Holy Family Memorial Inc Past Accepting new patients
Bsa Hospital LLC Past Accepting new patients
Texas Tech University Health Sciences Center El Paso Past Accepting new patients
Amarillo Area Healthcare Specialist Past Accepting new patients

Locations

1400 Wallace Blvd
Amarillo, TX 79106
Phone (806) 354-5585

1400 S Coulter St
Amarillo, TX 79106
Phone (806) 354-5600

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

Interoperability endpoints

  • Direct secure messaging: nicolelopez@ttuhsc.allscriptsdirect.net
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: nlopez21873@ahs.direct-ci.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1477587079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061708",
            "telephone_number": "806-414-9559",
            "fax_number": "806-351-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9559",
            "fax_number": "806-351-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L2431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151785608",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100848160A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151785606",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151785607",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84426756",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.