Mini K Locke, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000756 Issued in IA

Practice address

305 Montgomery St
Decorah, IA 52101-2721

Phone

(563) 382-8436

Fax

(563) 382-5140

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mlocke230904@direct.gundersenhealth.org

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.

• Palmer Lutheran Health Center, Inc.

  dba Gundersen Palmer Lutheran Hospital and Clinics

  • Critical Access Hospital
  • West Union, IA
  • NPI 1891744108
  NPD
• Northeast Iowa Community Action Corporation

  • Non-Surgical Family Planning Clinic/Center
  • Decorah, IA
  • NPI 1700953874
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508913443",
    "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",
            "telephone_number": "563-382-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012721",
            "telephone_number": "563-382-8436",
            "fax_number": "563-382-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "MINI",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "000756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Ann Lettington, LMHC
• Benjamin Avi Levinson, CRNA
• Heather Kay Levinson, MSN, ARNP
• Lighthouse Professional Counseling Services, LLC
• Kevin E Locke, M.D.
• Heidi J Loebig, RN
• Rebecca Loven, M.ED., LMHC
• Loving Touch Inc.
• Kaitlin Lubahn, T-LMFT
• Carol Ludeking, FNP-BC, DNP

• Medical Physician Assistant in Decorah, IA
• Providers in Decorah, IA by specialty
• Medical Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.