Active NPI
Kyre Lochan
- Physical Therapy Assistant
- Fayetteville, GA
National Provider Identifier
1003405911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA004586
- Practice address
- 1240 Georgia 54
Suite 404
Fayetteville, GA 30214 - Phone
- (470) 615-0485
- NPI assigned
- Jan 14, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA004586 | GA | Primary |
Addresses
Primary practice location
1240 Georgia 54
Suite 404
Fayetteville, GA 30214
Mailing address
2057 Swan CT
Riverdale, GA 30296-2853
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA004586 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennestone Hospital, Inc | Past | Accepting new patients |
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.
-
- Psychiatric Hospital Unit
- Atlanta, GA
- NPI 1689361438
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1003405911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2057 SWAN CT",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302962853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 GEORGIA 54",
"address_2": "SUITE 404",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "30214",
"telephone_number": "470-615-0485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCHAN",
"first_name": "KYRE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-15",
"certification_date": "2021-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA004586",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.