Active NPI
Mayra Lopez, LND
- Registered Dietitian
- Humacao, PR
National Provider Identifier
1780011957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 931
- Practice address
- 111 Calle Dufresne
Esq Manuel Cruz
Humacao, PR 00791 - Phone
- (787) 316-4371
- NPI assigned
- Oct 3, 2013
- Last updated
- Feb 13, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 931 | PR | Primary |
Addresses
Primary practice location
111 Calle Dufresne
Esq Manuel Cruz
Humacao, PR 00791
Mailing address
PO Box 1038
Bayamon, PR 00960
Phone (787) 360-7362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131107000564 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 5799910360 | Practice locations: Humacao, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1780011957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1038",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00960",
"telephone_number": "787-360-7362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 CALLE DUFRESNE",
"address_2": "ESQ MANUEL CRUZ",
"city": "HUMACAO",
"state": "PR",
"postal_code": "00791",
"telephone_number": "787-316-4371"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ",
"first_name": "MAYRA",
"name_prefix": "Mrs.",
"credential": "LND",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-03",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Humacao, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.