Individual provider Active NPI

Molly Jo Lopez

  • Family Nurse Practitioner
  • Cleburne, TX
National Provider Identifier
1487181889
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133199 Issued in TX
Practice address
2010 W Katherine P Raines Rd Ste 300
Cleburne, TX 76033-7447
Phone
(817) 556-3212
Fax
(817) 556-2388
NPI assigned
May 16, 2017
Last updated
Feb 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP133199 TX Primary

Addresses

Primary practice location

2010 W Katherine P Raines Rd Ste 300
Cleburne, TX 76033-7447

Mailing address

2010 W Katherine P Raines Rd Ste 300
Cleburne, TX 76033-7447
Phone (817) 556-3212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170718002698 TX Practitioner - Nurse Practitioner 7911277348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chisholm Trail Orthopedics and Sports Medicine, LLLPGroup PAC ID 7618916883, 13 clinicians

Practice addresses (Care Compare)

2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7447
Phone 8175563212201

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP133199TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chisholm Trail Orthopedics & Sports Medicine, LLLP CurrentSince Feb 1, 2018 Accepting new patients
Chisholm Trail Orthopedics & Sports Medicine, LLLP CurrentSince Feb 1, 2018 Accepting new patients

Locations

2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033
Phone (817) 556-3212

5540 Sycamore School Rd
Ste 312
Ft Worth, TX 76123
Phone (817) 556-3212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1487181889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD STE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337447",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD STE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337447",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MOLLY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.