Dr Mukaia Mitchom Lockett LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DR MUKAIA MITCHOM LOCKETT LLC

Practice address

2 Eagle Ctr Ste 1
O Fallon, IL 62269-1847

Phone

(618) 606-9119

Fax

(877) 781-4222

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Mukaia Mitchom Lockett, DCNPI 1588712624

Title

Owner

Phone

(618) 606-9119

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mukaia Mariama Mitchom Lockett, D.C.

  • Chiropractor
  • O Fallon, IL
  • NPI 1588712624
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1871189340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EAGLE CTR STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691847",
            "telephone_number": "618-606-9119",
            "fax_number": "877-781-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EAGLE CTR STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691847",
            "telephone_number": "618-606-9119",
            "fax_number": "877-781-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MUKAIA MITCHOM LOCKETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "MITCHOM LOCKETT",
        "authorized_official_first_name": "MUKAIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-606-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwen M Donley
• Randall E Dooley, MD
• Christina H Dothager, M.D.
• Jakia Douglas
• Mara Grace Downing, MD
• Susan Grace Drabing, FNP-BC
• Dawn Drewes, APN
• DRS Selberg & Rice PLLC
• Vincent Joseph Duenas, MD
• Victoria Dunahee

• Chiropractor in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.