Individual provider Active NPI

Kelli Locke, NP

  • Family Nurse Practitioner
  • Leominster, MA
National Provider Identifier
1184008278
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2266517 Issued in MA
Practice address
225 New Lancaster Rd
Leominster, MA 01453-4958
Phone
(978) 466-3208
Fax
(978) 840-1680
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2266517 MA
Family Nurse Practitioner 363LF0000X RN2266517 MA Primary

Addresses

Primary practice location

225 New Lancaster Rd
Leominster, MA 01453-4958

Mailing address

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (978) 466-3208

Other identifiers 1

IdentifierTypeStateIssuer
110110519AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160321001260 MA Practitioner - Nurse Practitioner 6800193723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

225 New Lancaster Rd
Leominster, MA 01453-4958
Phone (978) 534-6500

234 Washington St
Hudson, MA 01749-3735
Phone (508) 595-2700

241 N Main St
Leominster, MA 01453-2219
Phone (508) 595-2700

460 Southbridge St
Auburn, MA 01501-2442
Phone (508) 595-2700

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

Hospital & facility affiliations

  • Care Central Vna & Hospice Inc Home health agency, Gardner, MA, CCN 227003
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Heywood Hospital - Hospital, Gardner, MA, CCN 220095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2266517MAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. Nurse Practitioner CurrentSince Sep 25, 2019 Accepting new patients
Reliant Medical Group, Inc CurrentSince Jun 27, 2016 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

460 Southbridge St
Auburn, MA 01501
Phone (508) 595-2700

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

38 Highland Cmn E
Hudson, MA 01749
Phone (978) 287-8990

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

830 Constitution Ave
Littleton, MA 01460
Phone (978) 287-8990

5 Neponset St
#2
Worcester, MA 01606

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: kelli.locke.npi1184008278.reliant@direct.optumcare.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1184008278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "978-466-3208",
            "fax_number": "978-840-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 NEW LANCASTER RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014534958",
            "telephone_number": "978-466-3208",
            "fax_number": "978-840-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KELLI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-17",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2266517",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2266517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110110519A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.