Marissa Ann Lopez, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71012622A Issued in IN

Practice address

500 W Votaw St Ste a
Portland, IN 47371-1322

Phone

(260) 726-4350

Fax

(260) 726-9340

NPI assigned

Apr 28, 2022

Last updated

Jun 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Health Services CorpGroup PAC ID 5597679845, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Indiana University Health Jay, Inc. Hospital, Portland, IN, CCN 151320

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marissa.lopez.p1@direct.meridianhs.nextgenshare.com

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.

• Meridian Health Services Corp

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Muncie, IN
  • NPI 1992755490
  Medicare reassignment Care Compare group NPD
• Meridian Health Services Corp.

  • Federally Qualified Health Center (FQHC)
  • Montpelier, IN
  • NPI 1417838574
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Indiana University Health Jay, Inc.

  • Critical Access Hospital
  • Portland, IN
  • NPI 1801315692
  Care Compare affiliation

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1669117370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W VOTAW ST STE A",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473711322",
            "telephone_number": "260-726-4350",
            "fax_number": "260-726-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012622A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28212155A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Larrabee
• Tracy M Laux, NP
• Kathryn A Lawrence, MSW, LCSW
• Daniel J Livera, MD
• Leslie L Loesch, PTA
• Tina Luther, MA
• Rhandi Mackey
• Malcolm C. George, DDS
• Brandon M Mansoor, M.D.
• Chelsea Lauren Massman

• Family Nurse Practitioner in Portland, IN
• Providers in Portland, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.