NPIMap

Individual provider Active NPI

Alice Lee Lockman, FNP-BC

  • Family Nurse Practitioner
  • Montgomery, WV
National Provider Identifier
1487960407
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
47538 Issued in WV
Practice address
401 6TH Ave
Montgomery, WV 25136-2116
Phone
(304) 442-5151
Fax
(304) 442-7494
NPI assigned
Aug 27, 2010
Last updated
Sep 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 47538 WV Primary

Addresses

Primary practice location

401 6TH Ave
Montgomery, WV 25136-2116

Mailing address

401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000319 WV Practitioner - Nurse Practitioner 9537154505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia Health Right Inc.Group PAC ID 2163652983, 10 clinicians

Practice addresses (Care Compare)

1520 Washington St E
Charleston, WV 25311-2511
Phone 30441459315931

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Health Right, Inc. CurrentSince Jul 13, 2021 Accepting new patients
Montgomery General Hospital, Inc CurrentSince May 15, 2011 Accepting new patients
Montgomery General Hospital, Inc CurrentSince May 15, 2011 Accepting new patients
Montgomery Gen Cahgrp Past 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 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

  • Direct secure messaging: alice.lockman.1@12396.direct.athenahealth.com
  • Direct secure messaging: alice.lockman.1@12406.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12396/brand/1/csg/1/fhir/r4

Organizations & group practices 9

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1487960407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 6TH AVE",
            "city": "MONTGOMERY",
            "state": "WV",
            "postal_code": "251362116",
            "telephone_number": "304-442-5151",
            "fax_number": "304-442-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 6TH AVE",
            "city": "MONTGOMERY",
            "state": "WV",
            "postal_code": "251362116",
            "telephone_number": "304-442-5151",
            "fax_number": "304-442-7494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKMAN",
        "first_name": "ALICE",
        "middle_name": "LEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-27",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "47538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, WV

Sources for this page

Verify at the official NPI Registry.