Active NPI
Destiny H Locke, N.P.
- Family Medicine Physician
- McMinnville, TN
National Provider Identifier
1972543072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- APN0000007194
- Practice address
- 155 Health Way
Suite 2
MC Minnville, TN 37110-2658 - Phone
- (931) 473-4214
- Fax
- (931) 473-0666
- NPI assigned
- Jun 7, 2006
- Last updated
- May 22, 2008
- 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 Medicine Physician | 207Q00000X | APN0000007194 | TN | Primary |
Addresses
Primary practice location
155 Health Way
Suite 2
MC Minnville, TN 37110-2658
Mailing address
155 Health Way
Suite 2
MC Minnville, TN 37110-2658
Phone (931) 473-4214
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3719062 | Medicaid | TN | |
| 3732438 | Medicaid | TN | |
| 4167862 | Other | BCBST | |
| 3904079 | Medicaid | TN |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APN0000007194 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maury Regional Hospital | Past | Accepting new patients | |
| Maury Regional Ambulatory Care Center Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Columbia, TN
- NPI 1336190214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1972543072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 HEALTH WAY",
"address_2": "SUITE 2",
"city": "MC MINNVILLE",
"state": "TN",
"postal_code": "371102658",
"telephone_number": "931-473-4214",
"fax_number": "931-473-0666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 HEALTH WAY",
"address_2": "SUITE 2",
"city": "MC MINNVILLE",
"state": "TN",
"postal_code": "371102658",
"telephone_number": "931-473-4214",
"fax_number": "931-473-0666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKE",
"first_name": "DESTINY",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "APN0000007194",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3719062",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3732438",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "4167862",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3904079",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.