Active NPI
Edward Lopez
- Community Health Worker
- Reno, NV
National Provider Identifier
1720829682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- CHW1-5694
- Practice address
- 1905 E 4TH St
Reno, NV 89512-3789 - Phone
- (775) 786-4673
- NPI assigned
- Jun 4, 2024
- Sex
- Male
- 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 | CHW1-5694 | NV | Primary |
Addresses
Primary practice location
1905 E 4TH St
Reno, NV 89512-3789
Mailing address
580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673
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 |
|---|---|---|---|
| CHW1-5694 | NV | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717459200000",
"number": "1720829682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 W 5TH ST",
"city": "RENO",
"state": "NV",
"postal_code": "895034407",
"telephone_number": "775-786-4673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 E 4TH ST",
"city": "RENO",
"state": "NV",
"postal_code": "895123789",
"telephone_number": "775-786-4673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-04",
"certification_date": "2024-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NV",
"license": "CHW1-5694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.