Active NPI
Juanito F. Lopez Jr., M.D.
- Specialist
- Edgewood, MD
National Provider Identifier
1730175472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D14130
- Practice address
- 1012 Edgewood Rd
Edgewood, MD 21040-1606 - Phone
- (410) 671-7300
- Fax
- (410) 671-7312
- NPI assigned
- Sep 27, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | D14130 | MD | Primary |
Addresses
Primary practice location
1012 Edgewood Rd
Edgewood, MD 21040-1606
Mailing address
1012 Edgewood Rd
Edgewood, MD 21040-1606
Phone (410) 671-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 367561102 | Medicaid | MD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1730175472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1012 EDGEWOOD RD",
"city": "EDGEWOOD",
"state": "MD",
"postal_code": "210401606",
"telephone_number": "410-671-7300",
"fax_number": "410-671-7312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1012 EDGEWOOD RD",
"city": "EDGEWOOD",
"state": "MD",
"postal_code": "210401606",
"telephone_number": "410-671-7300",
"fax_number": "410-671-7312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "JUANITO",
"middle_name": "F.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-27",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "D14130",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "367561102",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edgewood, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.