Individual provider Active NPI

William Lockwood, MD

  • Infectious Disease Physician
  • Prescott, AZ
National Provider Identifier
1861478299
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
53831 Issued in AZ
Practice address
811 Ainsworth Dr Ste 103
Prescott, AZ 86301-1687
Phone
(928) 771-5550
Fax
(928) 445-9209
NPI assigned
Dec 18, 2005
Last updated
Dec 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 40316 CO
Infectious Disease Physician 207RI0200X 53831 AZ Primary

Addresses

Primary practice location

811 Ainsworth Dr Ste 103
Prescott, AZ 86301-1687

Mailing address

PO Box 10880
Prescott, AZ 86304-0880
Phone (928) 759-5987

Other identifiers 3

IdentifierTypeStateIssuer
53154231MedicaidCO
Z201654OtherAZMEDICARE PIN
259781MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53831AZMDInfectious Disease Physician
40316COMDInfectious Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1134864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1861478299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5987",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 AINSWORTH DR STE 103",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011687",
            "telephone_number": "928-771-5550",
            "fax_number": "928-445-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-18",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CO",
            "license": "40316",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "53831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53154231",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "Z201654",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259781",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.