MARK D. LOPEZ (NPI# 1518922079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518922079 |
| Entity Type | Individual |
| Full Name | MARK D. LOPEZ |
| Credential | MD |
| Practice Address |
1003 Willow Creek Rd Prescott AZ 86301-1641 |
| Mailing Address |
2965 W Crestview Dr Prescott AZ 86305-7014 |
| Practice Telephone | 9284452700 |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
29284 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 596489 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487014734 | Mark Lopez | Counselor | 8739 Santa Monica Blvd, West Hollywood, CA 90069-4507 | 2016-02-29 |
| 1518978113 | Mark Stephan Lopez II | Physical Therapy Assistant | 17 Willowbrook Ln, Rancho Santa Margarita, CA 92688-5514 | 2006-08-10 |
| 1487648051 | Mark T Lopez | Optometrist | 1026 Long Cove Rd, Gales Ferry, CT 06335-1812 | 2005-09-09 |
| 1538469937 | Mark Anthony Lopez | Social Worker | 2933 El Nido Dr, Altadena, CA 91001-4529 | 2010-11-01 |
| 1619147220 | Mark Anthony Lopez | Internal Medicine | 4700 Las Vegas Blvd N, Las Vegas, NV 89191-6600 | 2008-03-11 |
| 1053420257 | Mark D. Lopez | Pediatrics | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| Street Address |
1003 WILLOW CREEK RD |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528343 | Robert William Halterman | Family Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2005-06-15 |
| 1083211320 | Wendy E Nelson | Dietitian, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1668 | 2020-10-08 |
| 1750909008 | Shawn Jeffery Mitchell | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2020-07-13 |
| 1669019683 | Justin Earl Rogers | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-12-09 |
| 1477116911 | Anna Mattson | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-04-19 |
| 1790276608 | Phillip Allen Schafer | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301 | 2018-05-25 |
| 1144724618 | Richard Barclay Thompson | Respiratory Therapist, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2018-03-20 |
| 1245774397 | Stephen Green | Physician Assistant | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-12-08 |
| 1427500107 | Zachary Archer | Perfusionist | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-10-28 |
| 1952753675 | Candice Panton | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447214267 | William J. Thrift | Emergency Medicine | 801 Miller Valley Rd, Prescott, AZ 86301-1815 | 2006-04-17 |
| 1124121694 | Aileen Marie Kennedy | Emergency Medicine | 500 North Hwy 89, Prescott, AZ 86313 | 2006-09-07 |
| 1063469781 | Karin Vannieuwenhuizen | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-28 |
| 1619927514 | Andrew C Shuter | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-11 |
| 1487604559 | Andrew S Garff | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-11 |
| 1780633487 | Christopher J Lampe | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-09 |
| 1154370732 | Martin F Dekort | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-09 |
| 1508815192 | Andrew J Rounseville | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-05-09 |
| 1518922830 | Matthew G. Frankel | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-04-19 |
| 1891750113 | Robert M. Kec | Emergency Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2006-04-19 |
| Find all providers in PRESCOTT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.