Individual provider Active NPI

Tyler Lockridge, FNP-BC

  • Family Nurse Practitioner
  • Shelbyville, IN
National Provider Identifier
1609313691
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71006831A Issued in IN
Practice address
2451 Intelliplex Dr Ste 260
Shelbyville, IN 46176-8580
Phone
(317) 398-0121
NPI assigned
Jan 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 71006831A IN Primary

Addresses

Primary practice location

2451 Intelliplex Dr Ste 260
Shelbyville, IN 46176-8580

Mailing address

30 W Rampart St
Ste 200
Shelbyville, IN 46176-8846
Phone (317) 421-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221001623 IN Practitioner - Nurse Practitioner 8628352556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Major HospitalGroup PAC ID 0446167415, 100 clinicians

Practice addresses (Care Compare)

2451 Intelliplex Dr
Shelbyville, IN 46176-8580
Phone (317) 392-3211

Hospital & facility affiliations

  • Major Hospital Hospital, Shelbyville, IN, CCN 150097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71006831AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital CurrentSince Apr 1, 2019 Accepting new patients
Major Multispecialty Associates CurrentSince Jan 1, 2019 Accepting new patients
Major Multispecialty Associates CurrentSince Jan 1, 2019 Accepting new patients
X-Ray Physicians of Shelbyville PC Current Accepting new patients
Major Hospital CurrentSince Apr 1, 2019 Accepting new patients
Onsite Solutions Past Accepting new patients

Locations

2451 Intelliplex Dr
Ste 24
Shelbyville, IN 46176
Phone (317) 398-7337

2451 Intelliplex Dr
#210
Shelbyville, IN 46176
Phone (317) 421-1914

1626 E State Road 44
Ste 24
Shelbyville, IN 46176

2451 Intelliplex Dr
Ste 240
Shelbyville, IN 46176
Phone (317) 398-7337

2451 Intelliplex Dr
Ste 260
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 200
Shelbyville, IN 46176
Phone (317) 398-0121

30 W Rampart St
Ste 250
Shelbyville, IN 46176
Phone (317) 398-7337

1626 E State Road 44
Ste A
Shelbyville, IN 46176
Phone (317) 421-2012

2451 Intelliplex Dr
Shelbyville, IN 46176
Phone (317) 392-3211

Organizations & group practices 6

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 1

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": "1485475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1609313691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST",
            "address_2": "STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-421-2012",
            "fax_number": "317-398-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR STE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-398-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKRIDGE",
        "first_name": "TYLER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-27",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006831A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

Verify at the official NPI Registry.