Individual provider Active NPI

Anthony Lockridge, PHARMD

  • Pharmacist
  • Matteson, IL
National Provider Identifier
1881965358
Registry record updated Jan 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051037955 Issued in IL
Practice address
645 Primrose LN
Matteson, IL 60443-1762
Phone
(708) 283-1147
Fax
(773) 731-4761
NPI assigned
Jan 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051037955 IL Primary

Addresses

Primary practice location

645 Primrose LN
Matteson, IL 60443-1762

Mailing address

645 Primrose LN
Matteson, IL 60443-1762
Phone (708) 283-1147

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
051037955ILMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1326585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326585600000",
    "number": "1881965358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 PRIMROSE LN",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431762",
            "telephone_number": "708-283-1147",
            "fax_number": "773-731-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 PRIMROSE LN",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604431762",
            "telephone_number": "708-283-1147",
            "fax_number": "773-731-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKRIDGE",
        "first_name": "ANTHONY",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-15",
        "last_updated": "2012-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051037955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matteson, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2012; 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.