Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mariah Nicole Lopez, PA-C

Individual provider Physician Assistant · NPI 1639648322

Mrs. Mariah Nicole Lopez, PA-C is a Physician Assistant in Miamisburg, Ohio. Graduated from Nova Southeastern College of Osteo Medicine in 2018, 8 years ago. Practices with Kettering Independent Medical Group Inc, a 700-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
8
Trained at
Nova Southeastern College of Osteo Medicine
Licensed in
OH
In the registry since
2018
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4000 Miamisburg Centerville Rd Ste 230
Miamisburg, OH 45342-7615
Phone: (937) 433-5309
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.005750RX (OH)

Record details

NPI number1639648322
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedNovember 26, 2018
Last updated in NPPESAugust 16, 2022
Certification dateAugust 16, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolNOVA SOUTHEASTERN COLLEGE OF OSTEO MEDICINE
Graduated 2018 (8 years in practice)
Group practice Kettering Independent Medical Group Inc — 700 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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