KRISTIN J LOCKREM (NPI# 1467421008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467421008 |
| Entity Type | Individual |
| Full Name | KRISTIN J LOCKREM |
| Other Name | KRISTIN J MEADOWS |
| Credential | PA-C |
| Practice Address |
406 N State St Gobles MI 49055-9717 |
| Mailing Address |
551 Linn St Allegan MI 49010-1595 |
| Practice Telephone | 2696282196 |
| Practice Fax Number | 2696282363 |
| Mailing Telephone | 2696865800 |
| Mailing Fax Number | 2696865899 |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2016-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601003243 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 003243 | 01 |
| MI | BCBS MI | KM003243 | 01 |
| Street Address |
406 N STATE ST |
| City | GOBLES |
| State | MI |
| Zip Code | 49055-9717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780682237 | Eriberto Carrion | Family Medicine | 406 N State St, Gobles, MI 49055-9717 | 2005-07-08 |
| 1306323043 | Ascension Allegan Hospital | Clinic/Center | 406 N State St, Gobles, MI 49055-9717 | 2018-07-25 |
| 1962507608 | Health Centers Incorporated | Family Medicine | 406 N State St, Gobles, MI 49055-9717 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902332604 | Joseph John-moynihan Olsiewicz | Specialist/Technologist | 25038 County Road 388, Gobles, MI 49055 | 2017-05-02 |
| 1497207609 | Cornerstone Management Group LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 302 South State Street, Gobles, MI 49055 | 2016-11-04 |
| 1033467626 | Anita Ficsor Gutierrez | Family Medicine | 26648 County Road 653, Gobles, MI 49055 | 2012-08-29 |
| 1295054302 | Linda Lou Millek | Counselor | 18575 32nd St, Gobles, MI 49055 | 2010-05-28 |
| 1275750853 | Gregory Harry Doll | Pharmacist | 206 South State St., Gobles, MI 49055 | 2007-04-18 |
| 1093935439 | Joann Boyer | Technician, Other | 206 S. State Street, Gobles, MI 49055-0290 | 2007-04-26 |
| 1790902815 | Mary Lee Flesher | Pharmacist | 206 S. State Street, Gobles, MI 49055-0403 | 2007-04-19 |
| 1619194362 | Gary Olson Flesher | Pharmacist | 206 S. State Street, Gobles, MI 49055-0403 | 2007-04-20 |
| 1588029706 | Arthur Pruitt | Counselor | 40096 28th Ave, Gobles, MI 49055-8614 | 2015-12-16 |
| 1366806804 | Ashley Giuzio | Occupational Therapist | 18527 32nd St, Gobles, MI 49055-8633 | 2016-04-11 |
| Find all providers in zip 49055 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616687 | Alexandria Jaclyn Miller | Physician Assistant | 4700 Chipman Dr, Waterford, MI 48327-3413 | 2020-10-15 |
| 1639777287 | Piotr Z Purzycki | Physician Assistant | 41400 Dequindre Rd Ste 101, Sterling Heights, MI 48314-3751 | 2020-10-15 |
| 1013524859 | Amber Marie Lee | Physician Assistant | 2265 South Lindenroad, Suite A, Flint, MI 48532 | 2020-09-25 |
| 1326656844 | Dominic Farrell | Physician Assistant | 224 Portchester Rd, Holland, MI 49424-2628 | 2020-07-21 |
| 1982212072 | Alexandria Bower-nelson | Physician Assistant | 1302 Porter Drive, Charlotte, MI 48813 | 2020-07-15 |
| 1013535343 | Maria Pavia | Physician Assistant | 41302 Scarborough Ln, Novi, MI 48375-2893 | 2020-07-13 |
| 1073130241 | Kelly F Esper | Physician Assistant | 9043 Glenwood Ln, Northville, MI 48168-9129 | 2020-07-02 |
| 1811513971 | Tasha Baker | Physician Assistant | 5444 E Whitefeather Rd, Pinconning, MI 48650-8407 | 2020-06-24 |
| 1437770054 | Sterling Ryan Maxfield | Physician Assistant | 6187 Oak Grove Rd, Howell, MI 48855-8247 | 2020-05-05 |
| 1760018808 | Rachel Renee Mackmin | Physician Assistant | 41498 Mary Kay Dr, Clinton Township, MI 48038-1989 | 2020-03-20 |
| Find all providers with the same taxonomy | ||||
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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.