Active NPI
Denise Busbin Locklear, PA-C
- Physician Assistant
- Fayetteville, NC
National Provider Identifier
1689964967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-02826
- Practice address
- 2109 Valleygate Dr Ste 201
Fayetteville, NC 28304-3571 - Phone
- (910) 486-8880
- Fax
- (910) 486-8886
- NPI assigned
- Apr 7, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-02826 | NC | Primary |
Addresses
Primary practice location
2109 Valleygate Dr Ste 201
Fayetteville, NC 28304-3571
Mailing address
2109 Valleygate Dr Ste 201
Fayetteville, NC 28304-3571
Phone (910) 486-8880
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02826 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474329600000",
"number": "1689964967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 VALLEYGATE DR STE 201",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043571",
"telephone_number": "910-486-8880",
"fax_number": "910-486-8886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 VALLEYGATE DR STE 201",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043571",
"telephone_number": "910-486-8880",
"fax_number": "910-486-8886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKLEAR",
"first_name": "DENISE",
"middle_name": "BUSBIN",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-07",
"last_updated": "2016-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-02826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.