Individual provider Active NPI

Lillian Lockett Robertson, M.D.

  • Obstetrics & Gynecology Physician
  • Tacoma, WA
National Provider Identifier
1720137268
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD 60435457 Issued in WA
Practice address
1717 S J St
Ms 01-38
Tacoma, WA 98405-4933
Phone
(979) 292-5012
Fax
(713) 668-0469
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X J1463 TX
Obstetrics & Gynecology Physician 207V00000X MD 60435457 WA Primary

Addresses

Primary practice location

1717 S J St
Ms 01-38
Tacoma, WA 98405-4933

Mailing address

3534 Elmridge St
Houston, TX 77025-4112
Phone (979) 292-5012

Other identifiers 1

IdentifierTypeStateIssuer
034120801MedicaidTX

Other names 1

  • Dr. Lillian Doris Lockett Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20140910002772 WA Practitioner - Obstetrics/Gynecology 2769669449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Creighton University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Washington PCGroup PAC ID 0345364642, 44 clinicians

Practice addresses (Care Compare)

1717 J St
Tacoma, WA 98405-4933
Phone (864) 908-3530

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (864) 908-3530

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J1463TXMDObstetrics & Gynecology Physician
MD 60435457WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jun 23, 2014 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Jun 23, 2014 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

1717 S J St
Stop 101
Tacoma, WA 98405

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1717 S J St
#138
Tacoma, WA 98405
Phone (979) 292-5012

Interoperability endpoints

  • Direct secure messaging: lrobertson72063@fhsce.catholichealth.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1720137268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 ELMRIDGE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770254112",
            "telephone_number": "979-292-5012",
            "fax_number": "713-668-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "address_2": "MS 01-38",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "979-292-5012",
            "fax_number": "713-668-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LILLIAN",
        "middle_name": "LOCKETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J1463",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD  60435457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034120801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LILLIAN",
            "last_name": "LOCKETT",
            "middle_name": "DORIS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.