Individual provider Active NPI

Jennifer Lopez

  • Supports Brokerage Agency
  • Mogadore, OH
National Provider Identifier
1992307805
Registry record updated Nov 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
Practice address
3078 State Route 43
Mogadore, OH 44260-9773
Phone
(970) 314-1357
NPI assigned
Nov 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X Primary

Addresses

Primary practice location

3078 State Route 43
Mogadore, OH 44260-9773

Mailing address

3078 State Route 43
Mogadore, OH 44260-9773
Phone (970) 314-1357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1605398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605398400000",
    "number": "1992307805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 STATE ROUTE 43",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442609773",
            "telephone_number": "970-314-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3078 STATE ROUTE 43",
            "city": "MOGADORE",
            "state": "OH",
            "postal_code": "442609773",
            "telephone_number": "970-314-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-15",
        "last_updated": "2020-11-15",
        "certification_date": "2020-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mogadore, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.