Individual provider Active NPI

Michele L Lock, BSN,CEN,TCRN, VA-BC

  • General Practice Registered Nurse
  • Rochester, NY
National Provider Identifier
1780422204
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
640336 Issued in NY
Practice address
1729 Qualtrough Rd
Rochester, NY 14625-1328
Phone
(585) 261-8664
NPI assigned
Jul 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WG0000X 640336 NY Primary

Addresses

Primary practice location

1729 Qualtrough Rd
Rochester, NY 14625-1328

Mailing address

1729 Qualtrough Rd
Rochester, NY 14625-1328
Phone (585) 261-8664

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
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
640336NYMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1780422204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 QUALTROUGH RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146251328",
            "telephone_number": "585-261-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 QUALTROUGH RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146251328",
            "telephone_number": "585-261-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCK",
        "first_name": "MICHELE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "BSN,CEN,TCRN, VA-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "NY",
            "license": "640336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.