Organization Active NPI

Locklear Prime and Urgent Care

  • Family Nurse Practitioner
  • Pembroke, NC
National Provider Identifier
1023870508
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LOCKLEAR PRIME AND URGENT CARE
Practice address
10461 NC Highway 711
Pembroke, NC 28372
Phone
(910) 775-9292
Fax
(910) 775-9444
NPI assigned
Jan 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Authorized official

Name
Mrs. Millicent Joy Locklear, FNPNPI 1093144784
Title
Owener/Provider
Phone
(910) 775-9292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10461 NC Highway 711
Pembroke, NC 28372

Mailing address

22 Chayleajace Dr
Pembroke, NC 28372-1019
Phone (919) 316-5462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240506004702 NC Part B Supplier - Clinic/Group Practice 3971943028 Receives reassigned benefits from 1 practitioner
Practice locations: Pembroke, NC

National Provider Directory

National Provider Directory

Locations

10461 NC Highway 711
Pembroke, NC 28372
Phone (910) 775-9292

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1023870508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHAYLEAJACE DR",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283721019",
            "telephone_number": "919-316-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 NC HIGHWAY 711",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-775-9292",
            "fax_number": "910-775-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOCKLEAR PRIME AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "LOCKLEAR",
        "authorized_official_first_name": "MILLICENT",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "OWENER/PROVIDER",
        "authorized_official_telephone_number": "910-775-9292",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.