Individual provider Active NPI

Lillian Lockwood, MD

  • Emergency Medicine Physician
  • Leavenworth, KS
National Provider Identifier
1093777021
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
430083 Issued in KS
Practice address
3500 S 4TH St
Leavenworth, KS 66048-5043
Phone
(913) 680-6100
Fax
(913) 680-6156
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 430083 KS Primary

Addresses

Primary practice location

3500 S 4TH St
Leavenworth, KS 66048-5043

Mailing address

PO Box 331
Shawnee Mission, KS 66201-0331
Phone (913) 469-4244

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160209002831 KS Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 7517852254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
430083KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Anthony'S Hospital Association Past Accepting new patients
Emergency Physicians of Salina, LLC Emergency Medicine Past Accepting new patients
St. Anthony'S Hospital Association Past Accepting new patients
The Covenant Group PA Emergency Medicine Past Accepting new patients

Organizations & group practices 4

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1093777021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662010331",
            "telephone_number": "913-469-4244",
            "fax_number": "913-469-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 S 4TH ST",
            "city": "LEAVENWORTH",
            "state": "KS",
            "postal_code": "660485043",
            "telephone_number": "913-680-6100",
            "fax_number": "913-680-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "LILLIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "430083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, KS

Sources for this page

Verify at the official NPI Registry.