Tonya R. Jackson-Lockett, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04210702 Issued in WV

Practice address

200 12TH Street Ext
Princeton, WV 24740-2329

Phone

(304) 425-9541

NPI assigned

Aug 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Highlands Community Mental Health Center IncGroup PAC ID 4486629235, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern Highlands Community Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Princeton, WV
  • NPI 1740234673
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1346918968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON-LOCKETT",
        "first_name": "TONYA",
        "middle_name": "R.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "F04210702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Irwin
• Daniella Isaac
• J R Willis DC PC
• J. Kevin Martin, DDS, PLLC
• J. R. Willis, D.C., P.C.
• Alyssa Jackson
• Kegan Elizabeth Jackson, MSW, LGSW
• Pricilla Jackson
• Rafael Douglas Jackson
• Tisha James, RD, LD

• Family Nurse Practitioner in Princeton, WV
• Providers in Princeton, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.