Active NPI
Dennis L Lockhart, M.D.
- Specialist
- Bloomington, IL
National Provider Identifier
1033144308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- 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, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 036-053229 | IL | MD | Specialist |
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.