Individual provider Active NPI

Diana Lopez

  • Family Nurse Practitioner
  • Independence, MO
National Provider Identifier
1871225755
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2022016386 Issued in MO
Practice address
3889 S Jackson Dr
Independence, MO 64057-1927
Phone
(816) 698-8290
Fax
(816) 698-8291
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 53-81318-012 KS
Family Nurse Practitioner 363LF0000X 2022016386 MO Primary

Addresses

Primary practice location

3889 S Jackson Dr
Independence, MO 64057-1927

Mailing address

303 E 2ND St
Dearborn, MO 64439-7108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220927003257 KS Practitioner - Nurse Practitioner 7517343643 Reassigns benefits to 1 organization
I20241111001271 MO Practitioner - Nurse Practitioner 7517343643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Oncology Associates LLCGroup PAC ID 3779635172, 22 clinicians

Practice addresses (Care Compare)

3889 S Jackson Dr
Independence, MO 64057-1927
Phone (816) 698-8290

Hospital & facility affiliations

  • Centerpoint Medical Center Hospital, Independence, MO, CCN 260095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-81318-012KSMDFamily Nurse Practitioner
2022016386MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Oncology Associates LLC CurrentSince Nov 18, 2024 Accepting new patients

Locations

10600 Quivira Rd
Ste 110
Overland Park, KS 66215
Phone (913) 541-5550

12140 Nall Ave
Ste 200
Overland Park, KS 66209
Phone (913) 498-7409

10600 Quivira Rd
Ste 130
Overland Park, KS 66215
Phone (913) 541-5550

3889 S Jackson Dr
Independence, MO 64057
Phone (816) 698-8290

2340 E Meyer Blvd
Ste 546
Kansas City, MO 64132
Phone (816) 333-1376

2000 SE Blue Pkwy
Ste 240
Lees Summit, MO 64063
Phone (816) 282-5821

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1871225755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E 2ND ST",
            "city": "DEARBORN",
            "state": "MO",
            "postal_code": "644397108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3889 S JACKSON DR",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640571927",
            "telephone_number": "816-698-8290",
            "fax_number": "816-698-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "DIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "53-81318-012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2022016386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.