Individual provider Active NPI

Stephanie R Lockwood, MD

  • Family Medicine Physician
  • Fort Collins, CO
National Provider Identifier
1578509485
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41182 Issued in CO
Practice address
3519 Richmond Dr
Fort Collins, CO 80526-5995
Phone
(970) 204-0300
Fax
(970) 226-9041
NPI assigned
Jun 20, 2006
Last updated
Sep 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 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 41182 CO Primary

Addresses

Primary practice location

3519 Richmond Dr
Fort Collins, CO 80526-5995

Mailing address

1300 Riverside Ave Ste 102
Fort Collins, CO 80524-4353
Phone (970) 224-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20040923001141 CO Practitioner - Family Practice 8022086321 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41182COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VMD Primary Providers Colorado, Inc Family Medicine CurrentSince Sep 1, 2007 Accepting new patients
Medical Center of the Rockies PastSince Feb 1, 2020 Accepting new patients
Associates in Family Medicine, P.C. Family Medicine PastSince Oct 2, 2022 Accepting new patients
Poudre Valley Health Care,Inc Past Accepting new patients
Poudre Valley Health Care Inc Past Accepting new patients

Locations

1300 Riverside Ave
Ste 102
Fort Collins, CO 80524
Phone (970) 224-1670

3519 Richmond Dr
Fort Collins, CO 80526
Phone (970) 204-0300

1683 Main St
Windsor, CO 80550
Phone (970) 400-7618

Organizations & group practices 5

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1578509485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 RIVERSIDE AVE STE 102",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244353",
            "telephone_number": "970-224-1670",
            "fax_number": "970-495-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 RICHMOND DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805265995",
            "telephone_number": "970-204-0300",
            "fax_number": "970-226-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "STEPHANIE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "41182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.