Individual provider Active NPI

Janice Marie Vivaldi Lopez, MD

  • Obstetrics & Gynecology Physician
  • Alpharetta, GA
National Provider Identifier
1487101432
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
92661 Issued in GA
Practice address
3550 Preston Ridge Rd
Alpharetta, GA 30005-3821
Phone
(800) 611-1811
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 681694 TX
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 92661 GA Primary

Addresses

Primary practice location

3550 Preston Ridge Rd
Alpharetta, GA 30005-3821

Mailing address

13012 Gardner Dr
Alpharetta, GA 30009-2199
Phone (787) 203-7080

Other practice location 1

4801 Alberta Ave Fl 3
El Paso, TX 79905-2707
Phone (915) 215-8000

Other practice location 2

388 Zona Ind Reparada 2
Ponce, PR 00716-2347
Phone (787) 203-7080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221002000058 GA Practitioner - Obstetrics/Gynecology 0042696833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92661GAMDObstetrics & Gynecology Physician
681694TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Obstetrics & Gynecology CurrentSince Sep 6, 2022 Accepting new patients
Northside Hospital, Inc. Past Accepting new patients

Locations

3550 Preston Ridge Rd
Alpharetta, GA 30005
Phone (770) 663-3122

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Interoperability endpoints

  • Direct secure messaging: janice.vivaldilopez@direct.myhealthep.org

Organizations & group practices 2

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": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1487101432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13012 GARDNER DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092199",
            "telephone_number": "787-203-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 PRESTON RIDGE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053821",
            "telephone_number": "800-611-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "388 Zona Ind Reparada 2",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "007162347",
            "country_code": "US",
            "telephone_number": "787-203-7080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIVALDI LOPEZ",
        "first_name": "JANICE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "681694",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "92661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.