Active NPI
Charles J Lockwood, MD
- Maternal & Fetal Medicine Physician
- Tampa, FL
National Provider Identifier
1730162884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal & Fetal Medicine Physician
- License
- ME120422
- Practice address
- 2 Tampa General Cir
STC 4TH Floor
Tampa, FL 33606-3603 - Phone
- (813) 259-8500
- NPI assigned
- Nov 22, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal & Fetal Medicine Physician | 207VM0101X | 35098779 | OH | |
| Maternal & Fetal Medicine Physician | 207VM0101X | 026259 | CT | |
| Maternal & Fetal Medicine Physician | 207VM0101X | ME120422 | FL | Primary |
Addresses
Primary practice location
2 Tampa General Cir
STC 4TH Floor
Tampa, FL 33606-3603
Mailing address
PO Box 917770
Orlando, FL 32891-7770
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013106700 | Medicaid | FL | |
| 14V4B | Other | FL | BLUE CROSS BLUE SHIELD |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | clockwood84640@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026259 | CT | MD | Maternal & Fetal Medicine Physician |
| 35098779 | OH | MD | Maternal & Fetal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Service Association Inc | Current | Accepting new patients | |
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients |
Locations
12901 N 30th St
Tampa, FL 33612
Phone (813) 974-0703
2 Tampa General Cir
Fl 4
University of Tampa, FL 33606
Phone (813) 259-8500
Networks
- Freedom Health HMO Network
Interoperability endpoints
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
- clockwood84640@direct.tgh.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.
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- Obstetrics & Gynecology Physician
- Tampa, FL
- NPI 1629015797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1730162884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328917770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 TAMPA GENERAL CIR",
"address_2": "STC 4TH FLOOR",
"city": "TAMPA",
"state": "FL",
"postal_code": "336063603",
"telephone_number": "813-259-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKWOOD",
"first_name": "CHARLES",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-22",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "OH",
"license": "35098779",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "CT",
"license": "026259",
"primary": false
},
{
"code": "207VM0101X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
"state": "FL",
"license": "ME120422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "013106700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "14V4B",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "clockwood84640@direct.tgh.org",
"affiliation": "N",
"address_1": "2 Tampa General Cir",
"address_2": "STC 4th Floor",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336063603",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; 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.