Active NPI
Kelly Tay Locke, MD
- Family Medicine Physician
- Aspen, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 38023
- Practice address
- 401 Castle Creek Rd
Aspen, CO 81611-1159 - Phone
- (970) 279-4111
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 210985 | AK | |
| Family Medicine Physician | 207Q00000X | 38023 | CO | Primary |
Addresses
Primary practice location
401 Castle Creek Rd
Aspen, CO 81611-1159
Mailing address
401 Castle Creek Rd
Aspen, CO 81611-1159
Phone (970) 279-4111
Other practice location 1
1460 E Valley Rd Ste 103
Basalt, CO 81621-8412
Phone (970) 279-4111
Other practice location 2
3100 Tongass Ave
Ketchikan, AK 99901-5746
Phone (907) 228-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, AK, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040818000560 | CO | Practitioner - Family Practice | 5991778854 | Reassigns benefits to 7 organizations |
| I20231101000848 | AK | Practitioner - Family Practice | 5991778854 | Reassigns benefits to 2 organizations |
| I20231224000066 | TX | Practitioner - Family Practice | 5991778854 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kansas School of Med (KC/Wich/Sal), 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1204 Seward Ave
Searhc 1204 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611
1206 Seward Ave
Searhc 1206 Behavioral Health Sitka
Sitka, AK 99835-7359
Phone (907) 966-8611
1209 Seward Ave
Searhc 1209 Behavioral
Sitka, AK 99835-7359
Phone (907) 966-8611
222 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411
227 Tongass Dr
Sitka, AK 99835-9416
Phone (907) 966-2411
6000 Kanakanak Rd
Dillingham, AK 99576-0130
Phone (907) 842-5201
P O Box
Dillingham, AK 99576-0130
PO Box
Suite 130
Dillingham, AK 99576-0130
Phone (907) 842-5201
Hospital & facility affiliations
- Southeast Alaska Regional Health Consortium
- Peacehealth Ketchikan Medical Center
- Bristol Bay Dba Kanakanak Hospital
- Valley View Hospital Association
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210985 | AK | MD | Family Medicine Physician |
| 38023 | CO | MD | Family Medicine Physician |
Practice roles
Locations
37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040
3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000
3100 Tongass Ave
Ketchikan, AK 99901
Phone (907) 225-4104
222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423
401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192
1450 E Valley Rd
Unit 101
Basalt, CO 81621
Phone (970) 279-4111
1460 E Valley Rd
Ste 103
Basalt, CO 81621
Phone (970) 279-4111
1450 E Valley Rd
Unit 201
Basalt, CO 81621
Phone (970) 927-1757
1906 Blake Ave
Glenwood Springs, CO 81601
Phone (970) 384-7033
1906 Blake Ave
#C
Glenwood Springs, CO 81601
Phone (970) 384-6782
201 Kendall Dr
Lamar, CO 81052
Phone (719) 336-0261
Interoperability endpoints
- https://epicproxy.et1254.epichosted.com/FHIRProxy/api/FHIR/R4/
- ktlocke@direct.bbahc.org
- kelly.locke.2@9028.direct.athenahealth.com
- kelly.locke.1@14566.direct.athenahealth.com
Organizations & group practices 42
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.
-
- Multi-Specialty Clinic/Center
- Aspen, CO
- NPI 1003306168
CO, Family Medicine
-
- Federally Qualified Health Center (FQHC)
- Lamar, CO
- NPI 1700889151
CO
-
- Emergency Care Clinic/Center
- Glenwood Springs, CO
- NPI 1114654795
CO
-
- Clinic/Center
- Snowmass Village, CO
- NPI 1710942495
-
- Durable Medical Equipment & Medical Supplies
- Aspen, CO
- NPI 1942357363
Hospital & facility affiliations 41
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Ambulatory Surgical Clinic/Center
- Basalt, CO
- NPI 1649885849
Hospital
-
- General Acute Care Hospital
- Glenwood Springs, CO
- NPI 1982668133
Hospital
-
- Clinic/Center
- Tenakee Springs, AK
- NPI 1477721280
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1376546002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 CASTLE CREEK RD",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111159",
"telephone_number": "970-279-4111",
"fax_number": "970-927-3915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 CASTLE CREEK RD",
"city": "ASPEN",
"state": "CO",
"postal_code": "816111159",
"telephone_number": "970-279-4111"
}
],
"practiceLocations": [
{
"address_1": "1460 E Valley Rd Ste 103",
"address_purpose": "LOCATION",
"city": "Basalt",
"state": "CO",
"postal_code": "816218412",
"country_code": "US",
"telephone_number": "970-279-4111",
"fax_number": "970-927-3915",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3100 Tongass Ave",
"address_purpose": "LOCATION",
"city": "Ketchikan",
"state": "AK",
"postal_code": "999015746",
"country_code": "US",
"telephone_number": "907-228-8300",
"fax_number": "907-228-8440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOCKE",
"first_name": "KELLY",
"middle_name": "TAY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AK",
"license": "210985",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "38023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aspen, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.