NPIMap

Individual provider Active NPI

Rebecca Locke, DO

  • Family Medicine Physician
  • Meridian, ID
National Provider Identifier
1265672281
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-1069 Issued in ID
Practice address
3399 E Louise Dr Ste 100
Meridian, ID 83642-5212
Phone
(208) 887-6813
Fax
(208) 887-6884
NPI assigned
Mar 3, 2009
Last updated
May 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60222868 WA
Family Medicine Physician 207Q00000X O-1069 ID Primary

Addresses

Primary practice location

3399 E Louise Dr Ste 100
Meridian, ID 83642-5212

Mailing address

3399 E Louise Dr Ste 100
Meridian, ID 83642-5212
Phone (208) 887-6813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230619001423 OR Practitioner - Family Practice 8224208814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grande Ronde Hospital IncGroup PAC ID 0547170789, 97 clinicians

Practice addresses (Care Compare)

900 Sunset Dr
La Grande, OR 97850-1362

900 Sunset Dr
La Grande, OR 97850-1387
Phone (541) 963-8421

PO Box
Suite 3290
La Grande, OR 97850

PO Box
Suite 3290
La Grande, OR 97850-7290

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
O-1069IDMDFamily Medicine Physician
OP60222868WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grande Ronde Hospital, Inc. Family Medicine CurrentSince Jul 17, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Family Medicine CurrentSince Sep 1, 2017 Accepting new patients
Grande Ronde Hospital, Inc. CurrentSince Jul 17, 2023 Accepting new patients
Grande Ronde Hospital, Inc. Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

3399 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 288-2255

506 4th St
La Grande, OR 97850
Phone (541) 663-3138

900 Sunset Dr
La Grande, OR 97850
Phone (541) 963-8421

Interoperability endpoints

  • Direct secure messaging: rlocke2873299@wm.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1265672281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 E LOUISE DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425212",
            "telephone_number": "208-887-6813",
            "fax_number": "208-887-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3399 E LOUISE DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425212",
            "telephone_number": "208-887-6813",
            "fax_number": "208-887-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "REBECCA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60222868",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-1069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.