Active NPI
Mary Karen Lopez
- Registered Nurse
- Marina del Rey, CA
National Provider Identifier
1487282794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 629445
- Practice address
- 4650 Lincoln Blvd
Marina del Rey, CA 90292-6306 - Phone
- (310) 388-7179
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 629445 | NY | Primary |
Addresses
Primary practice location
4650 Lincoln Blvd
Marina del Rey, CA 90292-6306
Mailing address
421 W 162ND St Apt 1E
New York, NY 10032-8104
Phone (310) 388-7179
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 629445 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1487282794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 W 162ND ST APT 1E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100328104",
"telephone_number": "310-388-7179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 LINCOLN BLVD",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926306",
"telephone_number": "310-388-7179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MARY",
"middle_name": "KAREN",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "629445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.