Alice Lee Lockman, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Montgomery, WV
NPI 1487960407 · NPPES record last updated Sep 21, 2011
Key facts
- NPI
- 1487960407
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 47538 (WV)
- Practice address
- 401 6TH Ave
Montgomery, WV 25136-2116 - Phone
- (304) 442-5151
- Fax
- (304) 442-7494
- NPI assigned
- Aug 27, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- West Virginia Health Right Inc.
Practice addresses (Care Compare)
1520 Washington St E
Charleston, WV 25311-2511
Phone 30441459315931
Hospital & facility affiliations
- Charleston Area Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101202000319 | WV | Practitioner - Nurse Practitioner | 9537154505 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montgomery General Hospital, Inc | Current |
Accepting new patients | |
| West Virginia Health Right, Inc. | Current |
Accepting new patients | |
| Montgomery General Hospital, Inc | Current |
Accepting new patients | |
| Montgomery General Hospital, Inc | Past | Accepting new patients | |
| Montgomery General Hospital, Inc. | Past | Accepting new patients | |
| Montgomery General Hospital, Inc | Past | Accepting new patients | |
| Montgomery Gen Cahgrp | Past | Accepting new patients | |
| Montgomery General Hospital, Inc | Past | Accepting new patients | |
| Montgomery Gen Cahgrp | Past | Accepting new patients |
Locations
1520 Washington St E
Charleston, WV 25311
Phone (304) 343-7000
401 6th Ave
Montgomery, WV 25136
Phone (304) 442-5151
Interoperability endpoints
- alice.lockman.1@12406.direct.athenahealth.com
- alice.lockman.1@12396.direct.athenahealth.com
- https://api.platform.athenahealth.com/12396/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 47538 | WV | Yes |
Addresses
Primary practice location
401 6TH Ave
Montgomery, WV 25136-2116
Mailing address
401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-5151
Other providers in Montgomery, WV
- Kennedy Dental Office
- Carl L Kennedy
- Arpan Kohli
- Vicki Jean Legg
- Tyler Charles Lewis
- Willard Truman Long Jr.
- Bradley Gilbert Marple
- Michelle McCollam
- James David Miller
- Brook Mills
All providers in Montgomery, WV · Family Nurse Practitioner in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.