Gloria Lockwood, C-OPA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

51120-030 Issued in WI

Practice address

140 24TH St S
Wisconsin Rapids, WI 54494-1906

Phone

(715) 424-1881

Fax

(715) 423-1602

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Gloria Kenowith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922157957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 24TH ST S",
            "address_2": "PO BOX 8005",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544941906",
            "telephone_number": "715-424-1881",
            "fax_number": "715-423-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 24TH ST S",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544941906",
            "telephone_number": "715-424-1881",
            "fax_number": "715-423-1602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKWOOD",
        "first_name": "GLORIA",
        "credential": "C-OPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WI",
            "license": "51120-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "KENOWITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julia Lilly, O.D.
• Shannon Christie Lindner, APNP, AGPCNP, RN
• Timothy A Lippold, AU.D.
• Katherine Lisiecki, RN
• Cynthia J Little, MS,CCC-SLP
• Michele Losey, LPC-IT
• Demaris Losinski, APSW
• Etta Lovitt, MD
• Daniel M. Lucas, M.D.
• Hannah Luker

• Surgical Physician Assistant in Wisconsin Rapids, WI
• Providers in Wisconsin Rapids, WI by specialty
• Surgical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.