Individual provider Active NPI

Jose Antonio Lopez-Lago, M.D.

  • Emergency Medicine Physician
  • Selma, AL
National Provider Identifier
1861440950
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00013180 Issued in AL
Practice address
1015 Medical Center Pkwy
Selma, AL 36701-6748
Phone
(706) 582-2393
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00013180 AL Primary

Addresses

Primary practice location

1015 Medical Center Pkwy
Selma, AL 36701-6748

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other practice location 1

2016 S Alabama Ave
Monroeville, AL 36460-3096
Phone (251) 575-3111

Other identifiers 1

IdentifierTypeStateIssuer
051556701MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050407000613 AL Practitioner - Emergency Medicine 1759339708 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00013180ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Alabama Ed PLLC Emergency Medicine CurrentSince May 10, 2012 Accepting new patients
Community Hospital Inc CurrentSince Jun 1, 2010 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Mar 31, 2013 Accepting new patients
Emergency Staffing Solutions Inc Emergency Medicine CurrentSince Oct 14, 2012 Accepting new patients
Community Hospital Inc Current Accepting new patients
Nes Tennessee Inc Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients
J. Paul Jones Hospital CurrentSince Jul 1, 2008 Accepting new patients
Nes Tennessee Inc Emergency Medicine CurrentSince Feb 1, 2021 Accepting new patients
Community Hospital Inc CurrentSince Jun 1, 2010 Accepting new patients
Nes Tennessee Inc Emergency Medicine Current Accepting new patients
Community Hospital Inc Current Accepting new patients
Peach Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Adel Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients

Locations

83825 Highway 9
Ashland, AL 36251
Phone (256) 354-1195

401 S 8th Ave
Atmore, AL 36502
Phone (251) 368-2500

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

317 McWilliams Ave
Camden, AL 36726
Phone (334) 682-3911

4370 W Main St
Dothan, AL 36305
Phone (256) 332-1611

2016 S Alabama Ave
Monroeville, AL 36460
Phone (251) 575-3111

1725 Pine St
Montgomery, AL 36106
Phone (334) 293-8000

1015 Medical Center Pkwy
Selma, AL 36701
Phone (334) 418-4100

315 W Hickory St
Sylacauga, AL 35150
Phone (256) 249-5000

604 Stone Ave
Talladega, AL 35160
Phone (256) 362-8111

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

1330 Highway 231 S
Troy, AL 36081
Phone (334) 370-5000

5870 N Hiatus Rd
Tamarac, FL 33321
Phone (957) 377-2954

7300 State Highway 121
Ste 370374
McKinney, TX 75070

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1861440950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MEDICAL CENTER PKWY",
            "city": "SELMA",
            "state": "AL",
            "postal_code": "367016748",
            "telephone_number": "706-582-2393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2016 S Alabama Ave",
            "address_purpose": "LOCATION",
            "city": "Monroeville",
            "state": "AL",
            "postal_code": "364603096",
            "country_code": "US",
            "telephone_number": "251-575-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPEZ-LAGO",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00013180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051556701",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, AL

Sources for this page

Verify at the official NPI Registry.