Bradley Allen Locke, D.O.

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

55834-020 Issued in WI

Practice address

2793 Lineville Rd
Green Bay, WI 54313-7152

Phone

(920) 496-4700

NPI assigned

Jun 23, 2008

Last updated

Aug 5, 2014By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Allergy/Immunology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Hospital-Hospital Sisters-Third Order of St FrancisGroup PAC ID 5799694675, 593 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.81 of 100Reported as apm

Quality

85.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blocke50669@ewd.direct.hshs.org

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.

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • General Practice Physician
  • Green Bay, WI
  • NPI 1285613638

  Pediatrics

  Medicare reassignment Care Compare group NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba Prevea Sheboygan Health Center

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1275799413
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• St Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St. Nicholas Hospital

  • Internal Medicine Physician
  • Sheboygan, WI
  • NPI 1447737762
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health ENT

  • Otolaryngology Physician
  • Shawano, WI
  • NPI 1194314013
  NPD
• St Vincent Hospital-Hospital Sisters-Third Order of St Francis

  dba Prevea Health

  • Durable Medical Equipment & Medical Supplies
  • Green Bay, WI
  • NPI 1245042530
  NPD
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  dba St Nicholas Hospital

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1730184342
  NPD

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1336300276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2793 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137152",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2793 LINEVILLE RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543137152",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-23",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "55834",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "WI",
            "license": "55834-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Benedict Lisowski, MD
• Adam Lawrence Liss, MD
• Michael J Litrenta, NP
• Katie Lynn Lloyd, DO
• Richard Thomas Lochowitz, D.D.S.
• Liza Jo Locklear, RD CD CDE
• Susan Lockwood, LCSW
• Maria Elena Lodenkamp
• Lois Pulvermacher and Associates LLC (Crossing the Bridges)
• Lisa A Lokkken

• Pediatric Allergy/Immunology Physician in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Pediatric Allergy/Immunology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.