Individual provider Active NPI

Kevin E Locke, M.D.

  • Family Medicine Physician
  • Decorah, IA
National Provider Identifier
1427052877
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26136 Issued in IA
Practice address
901 Montgomery St
Decorah, IA 52101-2325
Phone
(563) 382-2911
Fax
(563) 387-3102
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26136 IA Primary

Addresses

Primary practice location

901 Montgomery St
Decorah, IA 52101-2325

Mailing address

1100 Skyline Dr
Decorah, IA 52101-2514

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klocke32434@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20041202000858 IA Practitioner - Family Practice 4082512306 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26136IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winneshiek Medical Center CurrentSince Mar 30, 1990 Accepting new patients
Winneshiek Medical Center CurrentSince Mar 30, 1990 Accepting new patients
Winneshiek Medical Center Current Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

901 Montgomery St
Decorah, IA 52101
Phone (319) 382-2911

114 Fisher Ave
Ossian, IA 52161
Phone (563) 532-9440

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

Interoperability endpoints

  • Direct secure messaging: klocke112454@uihcdirect.org
  • Direct secure messaging: klocke32434@ehrdirect.mayoclinicmsg.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.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1427052877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SKYLINE DR",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-2911",
            "fax_number": "563-387-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KEVIN",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "26136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klocke32434@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "901 Montgomery St",
            "city": "Decorah",
            "state": "IA",
            "country_code": "US",
            "postal_code": "521012325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

Verify at the official NPI Registry.