NPIMap

Individual provider Active NPI

Bruce A. Lockwood, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Fort Collins, CO
National Provider Identifier
1093774390
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
31928 Issued in CO
Practice address
1300 Oakridge Dr
Suite 130
Ft Collins, CO 80525-5733
Phone
(970) 377-9555
Fax
(970) 377-9559
NPI assigned
Mar 23, 2006
Last updated
Feb 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 31928 CO Primary

Addresses

Primary practice location

1300 Oakridge Dr
Suite 130
Ft Collins, CO 80525-5733

Mailing address

1300 Oakridge Dr
Suite 130
Ft Collins, CO 80525-5733
Phone (970) 377-9555

Other identifiers 1

IdentifierTypeStateIssuer
01319284MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050311000469 CO Practitioner - Physical Medicine and RehabilitationPractitioner - Neurology 0648168468 Reassigns benefits to 1 organization
I20170314001356 OR Practitioner - Physical Medicine and RehabilitationPractitioner - Other (Physician) 0648168468 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Neurology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurologic LLCGroup PAC ID 3870895360, 4 clinicians

Practice addresses (Care Compare)

Boulder, CO 80301
Phone (303) 888-4384

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31928COMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurologic, LLC CurrentSince Sep 30, 2017 Accepting new patients
Northwest Neuro Nerve Monitoring, LLC CurrentSince Feb 1, 2017 Accepting new patients
Neuro Iom Services Inc Neurology Past Accepting new patients
Neurologiciom Past Accepting new patients
Rehabilitation Associates of Colorado PC Physical Medicine & Rehabilitation PastSince Jan 1, 2023 Accepting new patients

Locations

4845 Pearl East Cir
Ste 101
Boulder, CO 80301
Phone (303) 447-7174

10940 S Parker Rd
Parker, CO 80134
Phone (303) 426-3927

1410 Oak St
Ste 100B
Eugene, OR 97401
Phone (541) 284-5358

4325 Commerce St
Ste 111506
Eugene, OR 97402
Phone (541) 284-8535

Interoperability endpoints

  • Direct secure messaging: blockw07@yourcarecommunity.org

Organizations & group practices 6

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1093774390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 OAKRIDGE DR",
            "address_2": "SUITE 130",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805255733",
            "telephone_number": "970-377-9555",
            "fax_number": "970-377-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OAKRIDGE DR",
            "address_2": "SUITE 130",
            "city": "FT COLLINS",
            "state": "CO",
            "postal_code": "805255733",
            "telephone_number": "970-377-9555",
            "fax_number": "970-377-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "BRUCE",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "31928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01319284",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.