Individual provider Active NPI

Dale Rodney Lockman, PA-C

  • Physician Assistant
  • Carmel, IN
National Provider Identifier
1154964740
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10002852A Issued in IN
Practice address
11700 N Meridian St
Carmel, IN 46032-4656
Phone
(317) 880-3900
Fax
(317) 880-0545
NPI assigned
Oct 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 10002852A IN Primary

Addresses

Primary practice location

11700 N Meridian St
Carmel, IN 46032-4656

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

1314 E Walnut St
Washington, IN 47501-2860
Phone (812) 240-9212

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlockman@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20191127002437 IN Practitioner - Physician Assistant 1658704911 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Care Associates, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Riverview Hospital CurrentSince Feb 1, 2021 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

11700 N Meridian St
Carmel, IN 46032
Phone (317) 688-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

Interoperability endpoints

  • Direct secure messaging: dlockman@direct.iuhealth.org

Organizations & group practices 7

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": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1154964740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 N MERIDIAN ST",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460324656",
            "telephone_number": "317-880-3900",
            "fax_number": "317-880-0545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1314 E Walnut St",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "IN",
            "postal_code": "475012860",
            "country_code": "US",
            "telephone_number": "812-240-9212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKMAN",
        "first_name": "DALE",
        "middle_name": "RODNEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-25",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002852A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlockman@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11700 N Meridian St",
            "city": "Carmel",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460324656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

Verify at the official NPI Registry.