Individual provider Active NPI

Amy C Lockwood

  • Gerontology Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1265508477
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
SP008205 Issued in PA
Practice address
3400 Spruce St
Ground Silverstein Building
Philadelphia, PA 19104-4206
Phone
(215) 662-6698
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP008205 PA Primary
Adult Health Nurse Practitioner 363LA2200X SP008205 PA

Addresses

Primary practice location

3400 Spruce St
Ground Silverstein Building
Philadelphia, PA 19104-4206

Mailing address

3400 Spruce St
Ground Silverstein Building
Philadelphia, PA 19104-4206
Phone (215) 662-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070430000502 PA Practitioner - Nurse Practitioner 7012013535 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Perelman School of Med at the University of Pennsylvania, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Medical Services IncGroup PAC ID 5597743344, 31 clinicians
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1001 Wallace St
Tucker Nursing Home
Philadelphia, PA 19123-2599
Phone (215) 235-1600

51 N 39TH St
Philadelphia, PA 19104-2640
Phone (215) 662-8214

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Medical Services, Inc. CurrentSince Jul 15, 2023 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn-Medical Group CurrentSince May 1, 2015 Accepting new patients
University of Penn - Medical Group Past Accepting new patients

Locations

160 Rock Hill Rd
Bala Cynwyd, PA 19004
Phone (610) 667-6080

160 Rock Hill Rd
Fl 1
Bala Cynwyd, PA 19004
Phone (610) 667-5460

1390 Camp Hill Rd
Ft Washington, PA 19034
Phone (215) 641-0600

3400 Spruce St
Ste G
Philadelphia, PA 19104
Phone (215) 662-8730

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1265508477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "GROUND SILVERSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "GROUND SILVERSTEIN BUILDING",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "AMY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP008205",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP008205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.