NPIMap

Individual provider Active NPI

Robert Alanson Lockwood, M.D.

  • Gastroenterology Physician
  • Boise, ID
National Provider Identifier
1588954101
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
M-14072 Issued in ID
Practice address
425 W Bannock St
Boise, ID 83702
Phone
(208) 343-6458
Fax
(208) 343-5031
NPI assigned
Apr 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X M-14072 ID Primary

Addresses

Primary practice location

425 W Bannock St
Boise, ID 83702

Mailing address

1301 Medical Center Dr
The Vanderbilt Clinic, Suite 1660
Nashville, TN 37232-0128

Other practice location 1

2235 E Gala St
Meridian, ID 83642-8026
Phone (208) 887-3724

Other practice location 2

1200 Garrity Blvd
Nampa, ID 83687-3402
Phone (208) 343-6458

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Boise Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20180713002533 ID Practitioner - GastroenterologyPractitioner - Internal Medicine 6406086248 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of South Alabama College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Gastroenterology Associates LLPGroup PAC ID 6002708773, 35 clinicians

Practice addresses (Care Compare)

425 W Bannock St
Boise, ID 83702-6035
Phone (208) 489-1431

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy55
Upper gastrointestinal (GI) endoscopy for acid reflux208

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-14072IDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners Gastroenterology CurrentSince Feb 18, 2018 Accepting new patients
Idaho Gastroenterology Associates, LLP Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients
Southern Idaho Health Partners LLC Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

425 W Bannock St
Boise, ID 83702
Phone (208) 343-1702

875 S Vanguard Way
Ste 310
Meridian, ID 83642
Phone (208) 343-6458

2235 E Gala St
Meridian, ID 83642
Phone (208) 489-1431

875 S Vanguard Way
Ste 300
Meridian, ID 83642
Phone (208) 488-0066

1200 Garrity Blvd
Nampa, ID 83687
Phone (208) 343-6458

1216 Garrity Blvd
Nampa, ID 83687
Phone (208) 342-7169

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

Interoperability endpoints

  • Direct secure messaging: robertlockwood@igallp.allscriptsdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1588954101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MEDICAL CENTER DR",
            "address_2": "THE VANDERBILT CLINIC, SUITE 1660",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372320128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83702",
            "telephone_number": "208-343-6458",
            "fax_number": "208-343-5031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2235 E Gala St",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428026",
            "country_code": "US",
            "telephone_number": "208-887-3724",
            "fax_number": "208-887-1682",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Garrity Blvd",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836873402",
            "country_code": "US",
            "telephone_number": "208-343-6458",
            "fax_number": "208-343-5031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "ROBERT",
        "middle_name": "ALANSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-15",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ID",
            "license": "M-14072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Boise",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Boise",
            "address_1": "425 W Bannock St",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "83702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.