Individual provider Active NPI

Ana Mercedes Lopez, PHD PSYD

  • Clinical Psychologist
  • Morehead City, NC
National Provider Identifier
1790993962
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
763 Issued in IA
Practice address
209 N 35TH St
Morehead City, NC 28557-3183
Phone
(515) 802-2487
NPI assigned
May 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 763 IA Primary

Addresses

Primary practice location

209 N 35TH St
Morehead City, NC 28557-3183

Mailing address

1038 Decatur Rd
Jacksonville, NC 28540-6829
Phone (515) 802-2487

Other practice location 1

200 Valencia Dr
Jacksonville, NC 28546-6311
Phone (515) 802-2487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000713 IA Practitioner - Clinical Psychologist 5597788117 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
763IAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Meditelecare of Iowa PLLC CurrentSince Mar 1, 2018 Accepting new patients
Multicultural International Counseling Enterprises, P.C. Current Accepting new patients
Multicultural Institute of Therapeutic Excellence Past Accepting new patients
T Med Behavioral Inc Clinical Past Accepting new patients

Locations

508 W Pearl St
#2
Afton, IA 50830

201 Hall St
#21
West Union, IA 52175

4242 Medical Dr
Ste 7100
San Antonio, TX 78229
Phone (210) 342-1906

Interoperability endpoints

  • Direct secure messaging: ana.lopez.1@30520.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1790993962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1038 DECATUR RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406829",
            "telephone_number": "515-802-2487",
            "fax_number": "800-426-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 N 35TH ST",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285573183",
            "telephone_number": "515-802-2487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Valencia Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285466311",
            "country_code": "US",
            "telephone_number": "515-802-2487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "ANA",
        "middle_name": "MERCEDES",
        "name_prefix": "Dr.",
        "credential": "PHD PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-19",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.