NPIMap

Individual provider Active NPI

Dale A Lockhert, M.D.

  • Internal Medicine Physician
  • Lake Ozark, MO
National Provider Identifier
1659369635
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000150390 Issued in MO
Practice address
1870 Bagnell Dam Blvd
Lake Ozark, MO 65049
Phone
(573) 365-2318
Fax
(573) 365-3009
NPI assigned
Oct 12, 2005
Last updated
Dec 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2000150390 MO Primary

Addresses

Primary practice location

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049

Mailing address

105 E Washington St
Kennett, MO 63857-2041
Phone (873) 888-1137

Other practice location 1

105 E Washington St
Kennett, MO 63857-2041
Phone (873) 888-1137

Other identifiers 1

IdentifierTypeStateIssuer
204980916MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110919000724 MO Practitioner - Internal Medicine 5597864751 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Regional Health SystemGroup PAC ID 9133026776, 132 clinicians

Practice addresses (Care Compare)

54 Hospital Dr
Osage Beach, MO 65065-3050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.19 of 100Reported as group
Promoting interoperability
100
Improvement activities
40
Cost
75.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4180AKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Regional Health System Current Accepting new patients
Lake Regional Health System CurrentSince Jan 1, 2019 Accepting new patients
Lake Regional Health System Internal Medicine CurrentSince Jan 1, 2019 Accepting new patients
Bariatric & Metabolic Institute LLC PastSince Aug 6, 2019 Accepting new patients

Locations

1870 Bagnell Dam Blvd
Lake Ozark, MO 65049
Phone (573) 365-2318

54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772

Interoperability endpoints

  • Direct secure messaging: dalelockhert@mhccaremail.com

Organizations & group practices 4

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.

Hospital & facility affiliations 11

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1659369635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E WASHINGTON ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572041",
            "telephone_number": "873-888-1137",
            "fax_number": "573-888-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 BAGNELL DAM BLVD",
            "city": "LAKE OZARK",
            "state": "MO",
            "postal_code": "65049",
            "telephone_number": "573-365-2318",
            "fax_number": "573-365-3009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 E Washington St",
            "address_purpose": "LOCATION",
            "city": "Kennett",
            "state": "MO",
            "postal_code": "638572041",
            "country_code": "US",
            "telephone_number": "873-888-1137",
            "fax_number": "573-888-0920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOCKHERT",
        "first_name": "DALE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2000150390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204980916",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ozark, MO

Sources for this page

Verify at the official NPI Registry.