Individual provider Active NPI

Asdrubal Ibarra Lopez, D.C.

  • Chiropractor
  • Spokane Valley, WA
National Provider Identifier
1477859783
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60205933 Issued in WA
Practice address
902 S Sullivan Rd
Spokane Valley, WA 99037-9754
Phone
(509) 922-1909
Fax
(509) 922-6648
NPI assigned
Feb 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CH 60205933 WA
Chiropractor 111N00000X CH60205933 WA Primary

Addresses

Primary practice location

902 S Sullivan Rd
Spokane Valley, WA 99037-9754

Mailing address

902 S Sullivan Rd
Spokane Valley, WA 99037-9754
Phone (509) 922-1909

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clinic@summitsportschiro.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120629000437 WA Practitioner - Chiropractic 3375708126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

902 S Sullivan Rd
Spokane Valley, WA 99037-9754
Phone (509) 922-1909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60205933WAMDChiropractor
CH 60205933WAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Orthopedics CurrentSince Dec 6, 2022 Accepting new patients
Asdrubal I Lopez, DC, PS CurrentSince Dec 7, 2015 Accepting new patients
Michael W. Fisk, D.C., P.S Past Accepting new patients
Brian Mather, PC Sports Physician PastSince Nov 15, 2002 Accepting new patients

Locations

1124 S Pines Rd
Spokane Valley, WA 99206
Phone (509) 922-1909

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24613/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1296691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1477859783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990379754",
            "telephone_number": "509-922-1909",
            "fax_number": "509-922-6648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S SULLIVAN RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990379754",
            "telephone_number": "509-922-1909",
            "fax_number": "509-922-6648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ASDRUBAL",
        "middle_name": "IBARRA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-03",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WA",
            "license": "CH 60205933",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60205933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clinic@summitsportschiro.com",
            "affiliation": "N",
            "endpointDescription": "clinic email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "offiee email address",
            "address_1": "902 S Sullivan Rd",
            "city": "Spokane Valley",
            "state": "WA",
            "country_code": "US",
            "postal_code": "990379754",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.