Individual provider Active NPI

Larry Lamont Lockett

  • Licensed Practical Nurse
  • Livonia, MI
National Provider Identifier
1740834902
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703108445 Issued in MI
Practice address
37450 Schoolcraft Rd Ste 110
Livonia, MI 48150-1000
Phone
(734) 458-4601
NPI assigned
Jul 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703108445 MI Primary

Addresses

Primary practice location

37450 Schoolcraft Rd Ste 110
Livonia, MI 48150-1000

Mailing address

4860 Harrison St
Wayne, MI 48184-2219
Phone (313) 772-1780

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

State licenses

LicenseStateTypeSpecialty
4703108445MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1740834902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 HARRISON ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842219",
            "telephone_number": "313-772-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37450 SCHOOLCRAFT RD STE 110",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501000",
            "telephone_number": "734-458-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKETT",
        "first_name": "LARRY",
        "middle_name": "LAMONT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703108445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.