Active NPI
Theodore Lockard, MD
- Family Medicine Physician
- Ankeny, IA
National Provider Identifier
1528075165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD-24369
- Practice address
- 2605 SW White Birch Dr
Ankeny, IA 50023-7204 - Phone
- (515) 643-7100
- Fax
- (515) 643-7145
- NPI assigned
- Aug 2, 2006
- 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 | 24369 | IA | |
| Family Medicine Physician | 207Q00000X | MD-24369 | IA | Primary |
Addresses
Primary practice location
2605 SW White Birch Dr
Ankeny, IA 50023-7204
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3020271 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24369 | IA | MD | Family Medicine Physician |
| MD-24369 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421971200000",
"number": "1528075165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-643-7100",
"fax_number": "515-643-7145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 SW WHITE BIRCH DR",
"city": "ANKENY",
"state": "IA",
"postal_code": "500237204",
"telephone_number": "515-643-7100",
"fax_number": "515-643-7145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKARD",
"first_name": "THEODORE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2015-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "24369",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "MD-24369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3020271",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ankeny, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.