Individual provider Active NPI

Heather Locke, CRNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1700426251
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1175233 Issued in AL
Practice address
4190 Belfort Rd Ste 352
Jacksonville, FL 32216-1407
Phone
(904) 372-3943
NPI assigned
Jan 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 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 1175233 AL Primary

Addresses

Primary practice location

4190 Belfort Rd Ste 352
Jacksonville, FL 32216-1407

Mailing address

4190 Belfort Rd Ste 352
Jacksonville, FL 32216-1407
Phone (904) 372-3943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200225000900 AL Practitioner - Nurse Practitioner 9638506033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35246-0001
Phone (205) 934-3460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1175233ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham CurrentSince Mar 1, 2021 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 1, 2021 Accepting new patients
University of Alabama at Birmingham CurrentSince Mar 1, 2021 Accepting new patients
University of Alabama at Birmingham Current Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

908 20th St S
Birmingham, AL 35205
Phone (205) 934-4108

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

Interoperability endpoints

  • Direct secure messaging: hjlocke@direct.uabmedicine.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578873600000",
    "number": "1700426251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 BELFORT RD STE 352",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161407",
            "telephone_number": "904-372-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 BELFORT RD STE 352",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161407",
            "telephone_number": "904-372-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "HEATHER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-13",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1175233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.