Individual provider Active NPI

Sandra Lockard, RN

  • Private Vehicle
  • Interlochen, MI
National Provider Identifier
1164201406
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
License
L263758564040 Issued in MI
Practice address
1530 Sleepy Hollow LN
Interlochen, MI 49643-9299
Phone
(317) 289-5582
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X L263758564040 MI Primary

Addresses

Primary practice location

1530 Sleepy Hollow LN
Interlochen, MI 49643-9299

Mailing address

1530 Sleepy Hollow LN
Interlochen, MI 49643-9299
Phone (317) 289-5582

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
L263758564040MIMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1164201406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 SLEEPY HOLLOW LN",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439299",
            "telephone_number": "317-289-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 SLEEPY HOLLOW LN",
            "city": "INTERLOCHEN",
            "state": "MI",
            "postal_code": "496439299",
            "telephone_number": "317-289-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKARD",
        "first_name": "SANDRA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "MI",
            "license": "L263758564040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Interlochen, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.