NPIMap

Individual provider Active NPI

Brett C. Lockman, DO

  • Interventional Pain Medicine Physician
  • Sonora, CA
National Provider Identifier
1003002742
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
20A15158 Issued in CA
Practice address
19468 Village Dr Ste 100
Sonora, CA 95370-9228
Phone
(209) 536-4776
Fax
(833) 302-0274
NPI assigned
Sep 17, 2007
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X N0221 TX
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 2015158 CA
Physical Medicine & Rehabilitation Physician 208100000X N0221 TX
Physical Medicine & Rehabilitation Physician 208100000X 2015158 CA
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 4156 IA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X N0221 TX
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 4156 IA
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 20A15158 CA
Pain Medicine Physician 208VP0000X 4156 IA
Interventional Pain Medicine Physician 208VP0014X 4156 IA
Interventional Pain Medicine Physician 208VP0014X 20A15158 CA Primary
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician 2081P0301X 20A15158 CA

Addresses

Primary practice location

19468 Village Dr Ste 100
Sonora, CA 95370-9228

Mailing address

18575 Lambert Lake Rd
Sonora, CA 95370-9333
Phone (214) 766-7817

Other identifiers 5

IdentifierTypeStateIssuer
0009606357OtherNCAETNA
1542XOtherNCBCBSNC
2235045OtherNCMAMSI
2915767OtherNCUHC
P00784683OtherNCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170410002277 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain ManagementPractitioner - Osteopathic Manipulative MedicinePractitioner - Sports MedicinePractitioner - Addiction Medicine 6103991245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Addiction Medicine, Interventional Pain Management, Osteopathic Manipulative Medicine, Sports Medicine
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19468 Village Dr
Sonora, CA 95370-9228
Phone (214) 766-7817

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2015158CAMDNeuromusculoskeletal Medicine & OMM Physician
20A15158CAMDBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician
N0221TXMDSports Medicine (Physical Medicine & Rehabilitation) Physician
4156IAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brett C Lockman DO Medical Corporation Neuromusculoskeletal Medicine & Omm CurrentSince Jan 25, 2017 Accepting new patients
American Pain & Wellness PA Physical Medicine & Rehabilitation PastSince Jun 11, 2023 Accepting new patients
American Pain & Wellness PA Past Accepting new patients
Genesis Health System Interventional Pain Medicine Past Accepting new patients
A Medical Advantage Healthcare Systems Associated Pain Medicine Past Accepting new patients
Carolina Rehabilitation and Surgical Associates, PA Physical Medicine & Rehabilitation PastSince Nov 17, 2025 Accepting new patients
Advanced Pain Control Center, PC Pain Medicine Past Accepting new patients
Denton Texas Health Management, PLLC Past Accepting new patients

Locations

19468 Village Dr
Ste 100
Sonora, CA 95370
Phone (209) 536-4776

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/29a5ccea-f4ab-4447-a191-56b20695970f/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1003002742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18575 LAMBERT LAKE RD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709333",
            "telephone_number": "214-766-7817",
            "fax_number": "833-302-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19468 VILLAGE DR STE 100",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709228",
            "telephone_number": "209-536-4776",
            "fax_number": "833-302-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKMAN",
        "first_name": "BRETT",
        "middle_name": "C.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-17",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "TX",
            "license": "N0221",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "2015158",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "N0221",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "2015158",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IA",
            "license": "4156",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "N0221",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IA",
            "license": "4156",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "20A15158",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IA",
            "license": "4156",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IA",
            "license": "4156",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "20A15158",
            "primary": true
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": "CA",
            "license": "20A15158",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0009606357",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "1542X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2235045",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2915767",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00784683",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.