Individual provider Active NPI

Roberta Lock, RN

  • Community Health Registered Nurse
  • Cortez, CO
National Provider Identifier
1073647681
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
92805 Issued in CO
Practice address
106 W North St
Cortez, CO 81321-3119
Phone
(970) 565-3056
Fax
(970) 565-0647
NPI assigned
Mar 15, 2007
Sex
Female
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
Community Health Registered Nurse 163WC1500X 92805 CO Primary

Addresses

Primary practice location

106 W North St
Cortez, CO 81321-3119

Mailing address

21190 Road U
Cortez, CO 81321-8713
Phone (970) 882-4795

Other identifiers 1

IdentifierTypeStateIssuer
16002237MedicaidCO

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
92805COMDCommunity Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Montezuma County Health Department Past Accepting new patients
Montezuma County Health Department 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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073647681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21190 ROAD U",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813218713",
            "telephone_number": "970-882-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W NORTH ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213119",
            "telephone_number": "970-565-3056",
            "fax_number": "970-565-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCK",
        "first_name": "ROBERTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CO",
            "license": "92805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16002237",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortez, CO

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.