Locke Wilson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G62500 Issued in CA

Practice address

430 Tee Dr
Healdsburg, CA 95448

Phone

(707) 484-6316

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: locke.wilson@hpg.eclinicaldirectplus.com

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528934400000",
    "number": "1649207481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 TEE DR",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954485101",
            "telephone_number": "707-484-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 TEE DR",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "95448",
            "telephone_number": "707-484-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LOCKE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G62500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Whisney
• Chelsea Rae Whitaker, DPT
• Judy Ann Widger
• Shawn Michael Widick, D.D.S.
• Stewart Williams, RD, CSG, LD
• Emily Wu, PHARM.D.
• Dana Diane Yee, D.M.D.
• Barbara Jeanne Young, MA, MFT
• Amy Carolina Zenteno, LCSW
• Zormeier Cosmetic Surgery & Longevity Center

• Family Medicine Physician in Healdsburg, CA
• Providers in Healdsburg, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; 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.