Individual provider Active NPI

Irene Katherina Lopez, APRN, FNP-C

  • Family Nurse Practitioner
  • Highland, IN
National Provider Identifier
1699484758
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013285A Issued in IN
Practice address
9008 Indianapolis Blvd
Highland, IN 46322-2501
Phone
(219) 513-8923
NPI assigned
Nov 17, 2022
Last updated
Dec 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71013285A IN Primary

Addresses

Primary practice location

9008 Indianapolis Blvd
Highland, IN 46322-2501

Mailing address

9008 Indianapolis Blvd
Highland, IN 46322-2501
Phone (219) 513-8923

Other names 1

  • Irene Panousis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221230000400 IN Practitioner - Nurse Practitioner 0547630980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1011 7TH St
Farmington, MN 55024-1544

1359 Glenn Dr
Crown Point, IN 46307-8276

6756 Fieldstone Dr
Burr Ridge, IL 60527-5298

PO Box
Suite 3063
Munster, IN 46321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
71013285AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthlinc, Inc. CurrentSince Aug 1, 2023 Accepting new patients
Healthlinc, Inc CurrentSince Aug 1, 2023 Accepting new patients
Healthlinc, Inc. Past Accepting new patients
Aesquivel Professional Corporation PastSince Nov 20, 2022 Accepting new patients

Locations

104 E Culver Rd
Ste 106
Knox, IN 46534
Phone (574) 772-7400

1708 High St
South Bend, IN 46613
Phone (574) 237-6640

1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173

1001 Sturdy Rd
#101
Valparaiso, IN 46383
Phone 21946271732468

2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100

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.

NPI Registry JSON

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

{
    "created_epoch": "1668643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1699484758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9008 INDIANAPOLIS BLVD",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222501",
            "telephone_number": "219-513-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9008 INDIANAPOLIS BLVD",
            "city": "HIGHLAND",
            "state": "IN",
            "postal_code": "463222501",
            "telephone_number": "219-513-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "IRENE",
        "middle_name": "KATHERINA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-17",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013285A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENE",
            "last_name": "PANOUSIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, IN

Sources for this page

Verify at the official NPI Registry.