Individual provider Active NPI

Millicent Joy Locklear, FNP-C

  • Family Nurse Practitioner
  • Pembroke, NC
National Provider Identifier
1093144784
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5006573 Issued in NC
Practice address
10461 Hwy 711
Pembroke, NC 28372
Phone
(910) 775-9292
Fax
(919) 775-9444
NPI assigned
Nov 4, 2013
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5006573 NC Primary
Pediatric Nurse Practitioner 363LP0200X 5006573 NC

Addresses

Primary practice location

10461 Hwy 711
Pembroke, NC 28372

Mailing address

812 Candy Park Rd
Pembroke, NC 28372-9129
Phone (910) 521-0201

Other practice location 1

812 Candy Park Rd
Pembroke, NC 28372-9129
Phone (910) 521-0201

Other identifiers 1

IdentifierTypeStateIssuer
5006573OtherNCFNP-C LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201027000418 NC Practitioner - Nurse Practitioner 9638599905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10461 NC Hwy 711
Pembroke, NC 28372-9108
Phone (910) 775-9292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Locklear Prime and Urgent Care Family CurrentSince Apr 15, 2024 Accepting new patients

Locations

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFDEDD/Endpoint/DFDEDD
  • Direct secure messaging: millicentlocklear@lumbertonc.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1093144784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 CANDY PARK RD",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729129",
            "telephone_number": "910-521-0201",
            "fax_number": "910-521-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10461 HWY 711",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "28372",
            "telephone_number": "910-775-9292",
            "fax_number": "919-775-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "812 Candy Park Rd",
            "address_purpose": "LOCATION",
            "city": "Pembroke",
            "state": "NC",
            "postal_code": "283729129",
            "country_code": "US",
            "telephone_number": "910-521-0201",
            "fax_number": "910-521-0773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKLEAR",
        "first_name": "MILLICENT",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006573",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5006573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP-C LICENSE",
            "identifier": "5006573",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, NC

Sources for this page

Verify at the official NPI Registry.