Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ellen Nicole Lockwood, PA-C

Individual provider Physician Assistant · NPI 1104584390

Ellen Nicole Lockwood, PA-C is a Physician Assistant in Tampa, Florida. Qualified in 2021, 5 years ago. Practices with Ohi West Medical Group II LLC, a 409-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2021
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3820 Northdale Blvd Ste 200
Tampa, FL 33624-1863
Phone: (813) 712-5702
Fax: (813) 377-1005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9115565 (FL)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1104584390
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 4, 2021
Last updated in NPPESOctober 21, 2022
Certification dateOctober 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ohi West Medical Group Ii Llc — 409 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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