Individual provider Active NPI

John Edward Lopes Jr., PA-C

  • Medical Physician Assistant
  • Mt Pleasant, MI
National Provider Identifier
1578610614
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004789 Issued in MI
Practice address
4273 Corporate Dr
Mt Pleasant, MI 48858
Phone
(989) 953-4357
NPI assigned
Jan 4, 2007
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601004789 MI Primary

Addresses

Primary practice location

4273 Corporate Dr
Mt Pleasant, MI 48858

Mailing address

4273 Corporate Dr
Mt Pleasant, MI 48858-5321
Phone (989) 953-4357

Other identifiers 1

IdentifierTypeStateIssuer
5601004789OtherMISTATE LICENSE

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004789MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Therapeutic Consultants PC PastSince Sep 15, 2018 Accepting new patients
Urgent Care Express PLLC Past Accepting new patients
BHG Lxxxiii, LLC PastSince Jan 1, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1578610614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4273 CORPORATE DR",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488585321",
            "telephone_number": "989-953-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4273 CORPORATE DR",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "48858",
            "telephone_number": "989-953-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPES",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5601004789",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.