Active NPI
Dianne Lynn Lockman, M.S., RN, CNS
- Prescribing (Medical) Psychologist
- Edina, MN
National Provider Identifier
1003037524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- License
- R055788
- Practice address
- 3919 W 44TH St Ste 200
Edina, MN 55424-1032 - Phone
- (952) 922-1977
- Fax
- (952) 922-1980
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | R055788 | MN | Primary |
Addresses
Primary practice location
3919 W 44TH St Ste 200
Edina, MN 55424-1032
Mailing address
3919 W 44TH St Ste 200
Edina, MN 55424-1032
Phone (952) 922-1977
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4H897LO | Other | MN | BLUE SHIELD INDIVIDUAL |
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
- Credentials
- Certified Nurse Specialist, Master of Science, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R055788 | MN | MD | Prescribing (Medical) Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Denise H. Bisanz, P.a. | Past | Accepting new patients | |
| Institute for Therapy & Behavior Change, LTD. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Edina, MN
- NPI 1336352665
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Edina, MN
- NPI 1548488331
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003037524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3919 W 44TH ST STE 200",
"city": "EDINA",
"state": "MN",
"postal_code": "554241032",
"telephone_number": "952-922-1977",
"fax_number": "952-922-1980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3919 W 44TH ST STE 200",
"city": "EDINA",
"state": "MN",
"postal_code": "554241032",
"telephone_number": "952-922-1977",
"fax_number": "952-922-1980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKMAN",
"first_name": "DIANNE",
"middle_name": "LYNN",
"credential": "M.S., RN, CNS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "",
"desc": "Psychologist, Prescribing (Medical)",
"state": "MN",
"license": "R055788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDIVIDUAL",
"identifier": "4H897LO",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.