Individual provider Active NPI

Dennis L Lockhart, M.D.

  • Specialist
  • Bloomington, IL
National Provider Identifier
1033144308
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
1008 N Main St
Bloomington, IL 61701-1784
Phone
(309) 829-5311
Fax
(309) 827-8027
NPI assigned
Jul 12, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X IL Primary

Addresses

Primary practice location

1008 N Main St
Bloomington, IL 61701-1784

Mailing address

PO Box 757
Bloomington, IL 61702-0757
Phone (309) 829-5311

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-053229ILMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033144308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617020757",
            "telephone_number": "309-829-5311",
            "fax_number": "309-827-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011784",
            "telephone_number": "309-829-5311",
            "fax_number": "309-827-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKHART",
        "first_name": "DENNIS",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.