NPIMap

Individual provider Active NPI

Guerrero Ivan Lopez

  • Physician Assistant
  • Smith Center, KS
National Provider Identifier
1831713429
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02397 Issued in KS
Practice address
921 E Highway 36
Smith Center, KS 66967-9582
Phone
(785) 282-6834
Fax
(785) 282-6331
NPI assigned
May 30, 2020
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 15-02397 KS Primary

Addresses

Primary practice location

921 E Highway 36
Smith Center, KS 66967-9582

Mailing address

PO Box 349
Smith Center, KS 66967-0349
Phone (785) 262-6834

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210127002196 KS Practitioner - Physician Assistant 1456765726 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains of Smith Co IncGroup PAC ID 2860300530, 14 clinicians

Practice addresses (Care Compare)

250 W 9TH St
Hoisington, KS 67544-1706
Phone (620) 653-2114

921 E Hwy 36
Smith Center, KS 66967-9582
Phone (785) 282-6834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Clara Barton Hospital Association, Inc. Hoisington Kansas CurrentSince Jun 18, 2023 Accepting new patients
Clay County Medical Center Current Accepting new patients
The Clara Barton Hospital Association, Inc. Hoisington Kansas CurrentSince Jun 18, 2023 Accepting new patients
Scott County Hospital CurrentSince Nov 8, 2023 Accepting new patients
Great Plains of Smith Co., Inc. CurrentSince Jun 10, 2023 Accepting new patients
Great Plains of Smith Co Inc Past Accepting new patients
The Clara Barton Hospital Association Inc Hoisington Kansas Past Accepting new patients
Rooks County Health Center Past Accepting new patients

Locations

617 Liberty St
Clay Center, KS 67432
Phone (785) 632-2144

250 W 9th St
Hoisington, KS 67544
Phone (620) 653-2114

201 Albert Ave
Scott City, KS 67871
Phone (620) 872-2187

921 E Highway 36
Smith Center, KS 66967
Phone (785) 282-6834

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/70091b8b-c363-42f8-b4d5-3b99f0fb60f1/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1831713429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 349",
            "city": "SMITH CENTER",
            "state": "KS",
            "postal_code": "669670349",
            "telephone_number": "785-262-6834",
            "fax_number": "785-282-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 E HIGHWAY 36",
            "city": "SMITH CENTER",
            "state": "KS",
            "postal_code": "669679582",
            "telephone_number": "785-282-6834",
            "fax_number": "785-282-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "GUERRERO",
        "middle_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-30",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smith Center, KS

Sources for this page

Verify at the official NPI Registry.