Active NPI
Jerry W Lockard, DO
- Nephrology Physician
- Ashland, KY
National Provider Identifier
1669466058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 02431
- Practice address
- 432 16TH St
Suite B
Ashland, KY 41101-7693 - Phone
- (606) 329-9335
- Fax
- (606) 324-6383
- NPI assigned
- Aug 31, 2005
- Last updated
- Aug 4, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 02431 | KY | Primary |
Addresses
Primary practice location
432 16TH St
Suite B
Ashland, KY 41101-7693
Mailing address
PO Box 2379
Ashland, KY 41105-2379
Phone (606) 329-9335
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0079552000 | Medicaid | WV | |
| 64024318 | Medicaid | KY | |
| 0129980 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02431 | KY | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri State Nephrology PSC | Past | Accepting new patients | |
| Tri State Nephrology Associates PSC | Nephrology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Nephrology Physician
- Ashland, KY
- NPI 1770594061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1669466058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2379",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411052379",
"telephone_number": "606-329-9335",
"fax_number": "606-324-6383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 16TH ST",
"address_2": "SUITE B",
"city": "ASHLAND",
"state": "KY",
"postal_code": "411017693",
"telephone_number": "606-329-9335",
"fax_number": "606-324-6383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKARD",
"first_name": "JERRY",
"middle_name": "W",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-31",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "KY",
"license": "02431",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0079552000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64024318",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0129980",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.