Active NPI
Elizabeth T. Locke, M.D.
- Internal Medicine Physician
- Las Vegas, NV
National Provider Identifier
1063500577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 13295
- Practice address
- 2851 N Tenaya Way
103
Las Vegas, NV 89128-0453 - Phone
- (702) 240-0088
- Fax
- (702) 240-5954
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G85351 | CA | |
| Internal Medicine Physician | 207R00000X | 13295 | NV | Primary |
Addresses
Primary practice location
2851 N Tenaya Way
103
Las Vegas, NV 89128-0453
Mailing address
5701 W. Charleston Blvd.
Suite 100
Las Vegas, NV 89146
Phone (702) 877-9514
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063500577 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G85351 | CA | MD | Internal Medicine Physician |
| 13295 | NV | MD | Internal Medicine Physician |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Las Vegas, NV
- NPI 1023721065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267660800000",
"number": "1063500577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 W. CHARLESTON BLVD.",
"address_2": "SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89146",
"telephone_number": "702-877-9514",
"fax_number": "702-877-0399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2851 N TENAYA WAY",
"address_2": "103",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891280453",
"telephone_number": "702-240-0088",
"fax_number": "702-240-5954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKE",
"first_name": "ELIZABETH",
"middle_name": "T.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2010-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G85351",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NV",
"license": "13295",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1063500577",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.