Active NPI
Khelli Ameke Lockridge, DNP, FNP-C
- Family Nurse Practitioner
- Vicksburg, MS
National Provider Identifier
1962073080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 904688
- Practice address
- 102 Pecan Blvd
Vicksburg, MS 39183-8766 - Phone
- (601) 985-8029
- NPI assigned
- Jul 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 904688 | MS | Primary |
Addresses
Primary practice location
102 Pecan Blvd
Vicksburg, MS 39183-8766
Mailing address
PO Box 746079
Atlanta, GA 30374-6079
Phone (773) 352-1515
Other practice location 1
4541 N State St
Jackson, MS 39206-5308
Phone (601) 533-7017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904688 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Health Network LLC | Current | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
232 Market St
Jackson, MS 39232
Phone (588) 498-6767
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1962073080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746079",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746079",
"telephone_number": "773-352-1515",
"fax_number": "312-929-0373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 PECAN BLVD",
"city": "VICKSBURG",
"state": "MS",
"postal_code": "391838766",
"telephone_number": "601-985-8029"
}
],
"practiceLocations": [
{
"address_1": "4541 N State St",
"address_purpose": "LOCATION",
"city": "Jackson",
"state": "MS",
"postal_code": "392065308",
"country_code": "US",
"telephone_number": "601-533-7017",
"fax_number": "312-929-0373",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOCKRIDGE",
"first_name": "KHELLI",
"middle_name": "AMEKE",
"name_prefix": "Mrs.",
"credential": "DNP, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-09",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "904688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vicksburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.