Active NPI
Sandra Jane Lopez, CHA IV
- Community Health Worker
- Cold Bay, AK
National Provider Identifier
1720305667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 08-964-III
- Practice address
- 65 Airport Rd
Cold Bay, AK 99571 - Phone
- (907) 532-2000
- Fax
- (907) 532-2001
- NPI assigned
- May 3, 2010
- Last updated
- May 3, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | 08-964-III | AK | Primary |
Addresses
Primary practice location
65 Airport Rd
Cold Bay, AK 99571
Mailing address
3380 C Street,
Ste. 100
Anchorage, AK 99503-3949
Phone (907) 277-1440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CL6515 | Medicaid | AK |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08-964-III | AK | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272844800000",
"number": "1720305667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 C STREET,",
"address_2": "STE. 100",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995033949",
"telephone_number": "907-277-1440",
"fax_number": "907-277-1446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 AIRPORT RD",
"city": "COLD BAY",
"state": "AK",
"postal_code": "99571",
"telephone_number": "907-532-2000",
"fax_number": "907-532-2001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "SANDRA",
"middle_name": "JANE",
"credential": "CHA IV",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-03",
"last_updated": "2010-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "AK",
"license": "08-964-III",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CL6515",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cold Bay, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.