Active NPI
Ileana Marie Lopez Colon, LND
- Registered Dietitian
- Toa Baja, PR
National Provider Identifier
1831466580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1452
- Practice address
- #2507 Ave. Boulevard
Toa Baja, PR 00949 - Phone
- (787) 688-4232
- NPI assigned
- Nov 23, 2011
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1452 | PR | Primary |
Addresses
Primary practice location
#2507 Ave. Boulevard
Toa Baja, PR 00949
Mailing address
Urb. Monte Verde Street Golondrina 201
Dorado, PR 00646
Phone (787) 688-4232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140927000073 | PR | Practitioner - Registered Dietitian Or Nutrition Professional | 7810117736 | Practice locations: Toa Baja, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1452 | PR | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1831466580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB. MONTE VERDE STREET GOLONDRINA 201",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-688-4232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "#2507 AVE. BOULEVARD",
"city": "TOA BAJA",
"state": "PR",
"postal_code": "00949",
"telephone_number": "787-688-4232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ COLON",
"first_name": "ILEANA",
"middle_name": "MARIE",
"credential": "LND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-23",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PR",
"license": "1452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toa Baja, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; 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.