Active NPI
Chrissy A Lopez, M.D.
- Pediatric Gastroenterology Physician
- Atlanta, GA
National Provider Identifier
1629364021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Gastroenterology Physician
- License
- 76313
- Practice address
- 1400 Tullie Rd NE
Atlanta, GA 30329-2309 - Phone
- (404) 785-5437
- NPI assigned
- Jun 23, 2011
- Last updated
- Oct 13, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 4301099007 | MI | |
| Pediatrics Physician | 208000000X | 4301099007 | MI | |
| Pediatrics Physician | 208000000X | 4301099007 | MN | |
| Pediatric Gastroenterology Physician | 2080P0206X | 76313 | GA | Primary |
Addresses
Primary practice location
1400 Tullie Rd NE
Atlanta, GA 30329-2309
Mailing address
1400 Tullie Rd NE
Atlanta, GA 30329-2309
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161107001686 | GA | Order and Referring Only - Pediatric Medicine | 3678799277 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301099007 | MN | MD | Pediatrics Physician |
| 76313 | GA | MD | Pediatric Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| Choa Multispecialty, LLC | Pediatrics | Past | Accepting new patients |
| Egleston Children's Hospital at Emory University, Inc. | Past | Accepting new patients | |
| Arthur M. Blank Hospital, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Children's Hospital
- Atlanta, GA
- NPI 1689744450
-
- Pediatrics Physician
- Brookhaven, GA
- NPI 1437493467
-
- Pediatric Emergency Medicine (Pediatrics) Physician
- Atlanta, GA
- NPI 1558416701
-
dba Memorial Hospital and Manor
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570924800000",
"number": "1629364021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 TULLIE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 TULLIE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303292309",
"telephone_number": "404-785-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "CHRISSY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-23",
"last_updated": "2019-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "4301099007",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301099007",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "4301099007",
"primary": false
},
{
"code": "2080P0206X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Gastroenterology",
"state": "GA",
"license": "76313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.