Individual provider Active NPI

Angelica Maria Lopez, MD

  • Pediatrics Physician
  • Enid, OK
National Provider Identifier
1689261877
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39579 Issued in OK
Practice address
5320 W Chestnut Ave
Enid, OK 73703-3563
Phone
(580) 701-0100
NPI assigned
Dec 22, 2020
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 39579 OK Primary

Addresses

Primary practice location

5320 W Chestnut Ave
Enid, OK 73703-3563

Mailing address

5320 W Chestnut Ave
Enid, OK 73703-3563
Phone (580) 701-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729002089 OK Practitioner - Pediatric Medicine 7113434747 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39579OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Salt Plains Health Center, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Great Salt Plains Health Center, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Great Salt Plains Health Center, Inc. Pediatrics Past Accepting new patients
Great Salt Plains Health Center Past Accepting new patients
Great Salt Plains Health Center, Inc. Past Accepting new patients
Great Salt Plains Health Center, Inc. Past Accepting new patients
Great Salt Plains Health Center, Inc. Past Accepting new patients

Locations

310 E Walnut
Canton, OK 73724
Phone (580) 886-2200

405 S Oklahoma Ave
Cherokee, OK 73728
Phone 87724284756012

205 W Maple Ave
Ste 1000
Enid, OK 73701
Phone (580) 233-2900

231 S 30th St
Enid, OK 73701
Phone (580) 215-6937

5320 W Chestnut Ave
Enid, OK 73703
Phone (580) 233-2900

619 N Front St
Medford, OK 73759
Phone (580) 395-3200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAIDAD

Organizations & group practices 7

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": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1689261877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 W CHESTNUT AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033563",
            "telephone_number": "580-701-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W CHESTNUT AVE",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737033563",
            "telephone_number": "580-701-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ANGELICA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "39579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

Verify at the official NPI Registry.