Active NPI
G Michael Lopez, M.D.
- Nurse Practitioner
- Las Vegas, NM
National Provider Identifier
1912337353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- CNP00739
- Legal business name
- G MICHAEL LOPEZ, M.D.
- Practice address
- 105 Mills Ave Ste 300
Las Vegas, NM 87701-4169 - Phone
- (505) 425-9311
- Fax
- (505) 425-9047
- NPI assigned
- Nov 21, 2013
- Organization subpart
- Yes
- Parent organization
- G MICHAEL LOPEZ, M.D.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. G Michael Lopez, M.D.
- Title
- Owner
- Phone
- (505) 425-9311
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CNP00739 | NM | Primary |
Addresses
Primary practice location
105 Mills Ave Ste 300
Las Vegas, NM 87701-4169
Mailing address
105 Mills Ave Ste 300
Las Vegas, NM 87701-4169
Phone (505) 425-9311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568 | Other | NM | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider Directory- Tax ID family
- G Michael Lopez
- Part of
- G Michael Lopez
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Internal Medicine Physician
- Las Vegas, NM
- NPI 1891925848
Interoperability endpoints
- https://api.platform.athenahealth.com/8441/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Las Vegas, NM
- NPI 1003973397
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1384992000000",
"number": "1912337353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MILLS AVE STE 300",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014169",
"telephone_number": "505-425-9311",
"fax_number": "505-425-9047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MILLS AVE STE 300",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014169",
"telephone_number": "505-425-9311",
"fax_number": "505-425-9047"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "G MICHAEL LOPEZ, M.D.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "G MICHAEL LOPEZ, M.D.",
"enumeration_date": "2013-11-21",
"last_updated": "2013-11-21",
"status": "A",
"authorized_official_last_name": "LOPEZ",
"authorized_official_first_name": "G",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "505-425-9311",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "NM",
"license": "CNP00739",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1568",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.