Darrell R Lockwood, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD08631 Issued in OR

Practice address

24900 SE Stark St
Ste 109, Gresham Internal Medicine Clinic
Gresham, OR 97030

Phone

(503) 667-1015

Fax

(503) 667-0406

NPI assigned

Jan 6, 2006

Last updated

Dec 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198022400000",
    "number": "1255319497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972813200",
            "telephone_number": "503-667-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24900 SE STARK ST",
            "address_2": "STE 109, GRESHAM INTERNAL MEDICINE CLINIC",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-667-1015",
            "fax_number": "503-667-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "DARRELL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2007-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD08631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231548",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Litzenberg
• Stephany Lo
• Marcos Edmundo Lobato-Arroyo, PHARMD, BCPS
• Taralea Jean Locke, LMT
• Virginia Lockhart, RN
• Shekinah Elizabeth Loconte
• Bethany Joy Loehrke, CPM, LDM
• Patrick Lohse, PMHNP-BC
• Nigel M Longland, DO
• Dawnette Kae Looking, CRM

• Internal Medicine Physician in Gresham, OR
• Providers in Gresham, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; 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.