KELLY LOCK (NPI# 1003828575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003828575 |
| Entity Type | Individual |
| Full Name | KELLY LOCK |
| Credential | PA-C |
| Practice Address |
6450 Folsom Dr Beaumont TX 77706-7269 |
| Mailing Address |
1220 Hillside Ln Lumberton TX 77657-9056 |
| Practice Telephone | 4098350524 |
| Practice Fax Number | 4098350632 |
| Mailing Telephone | (409) 755-0980 |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA04685 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5030 Hwy 69 South, Beaumont, TX 77705 | 4097262550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771613 | Kelly Meginnis Lock | Nurse Anesthetist, Certified Registered | 7601 Osler Dr, Towson, MD 21204-7700 | 2020-08-19 |
| Street Address |
6450 FOLSOM DR |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706-7269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538160726 | Jay C. Proctor IIi | Family Medicine | 6450 Folsom Dr, Beaumont, TX 77706-7269 | 2005-08-10 |
| 1184132532 | Aaran Michelle Gassiott | Nurse Practitioner | 6450 Folsom Dr, Beaumont, TX 77706-7269 | 2018-01-19 |
| 1306209721 | Waylon Casey Bergeron | Nurse Practitioner | 6450 Folsom Dr, Beaumont, TX 77706-7269 | 2016-04-02 |
| 1760782635 | Nighthawk Physicians of Texas, Pa | Radiology | 6450 Folsom Dr, Beaumont, TX 77706-7269 | 2010-10-26 |
| 1114059516 | Valerie Johnson | Physician Assistant | 6450 Folsom Dr, Beaumont, TX 77706-7269 | 2007-03-12 |
| 1942365564 | Shelby Odell Church Jr. | Physician Assistant | 6450 Folsom Dr, Beaumont Family Practice Associates, Beaumont, TX 77706-7269 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699239145 | Michael Delauney Dukate | Physician Assistant | 2965 Harrison St Ste 220, Beaumont, TX 77702-1149 | 2019-01-29 |
| 1427561786 | Colette Lavoy | Physician Assistant | 81 Highland Springs Ave Ste 100, Beaumont, CA 92223-3170 | 2017-11-08 |
| 1639621758 | Jason Allen Fondrick | Physician Assistant | 3030 North St Ste 430, Beaumont, TX 77702-1434 | 2016-10-25 |
| 1457806424 | Adriana Barrier | Physician Assistant | 1361 Mandrake Way, Beaumont, CA 92223-8467 | 2016-08-19 |
| 1235510504 | Randy Steven Yergenson | Physician Assistant | 222 Drake Ave, Beaumont, CA 92223-7512 | 2015-06-12 |
| 1376937003 | Winnie Community Hospital LLC | Physician Assistant | 85 Ih 10 N Ste 112, Beaumont, TX 77707 | 2015-03-19 |
| 1134540560 | Tommy Kent Sims | Physician Assistant | 5030 Highway 69 S, Beaumont, TX 77705-1258 | 2014-01-03 |
| 1396084992 | Courtney Marie Guidry | Physician Assistant | 755 N 11th St Ste P5200, Beaumont, TX 77702 | 2013-02-04 |
| 1285911412 | Nicholas Rene Alonzo | Physician Assistant | 81 Highland Springs Ave Ste 103, Beaumont, CA 92223-3170 | 2011-11-16 |
| 1770673782 | Stephen Livain Richard | Physician Assistant | 2890 N St, Christus Minor Care Clinic, Beaumont, TX 77702 | 2006-10-13 |
| Find all providers in BEAUMONT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.