NPIMap

Individual provider Active NPI

Karin Lockridge, M.S., CCC-A

  • Audiologist
  • Atlanta, GA
National Provider Identifier
1053621573
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
9089 Issued in NC
Practice address
5670 Peachtree Dunwoody Rd
Suite 1280
Atlanta, GA 30342-1699
Phone
(404) 257-1589
Fax
(404) 303-1950
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD003057 GA
Audiologist 231H00000X 147.000630 IL
Audiologist 231H00000X 9089 NC Primary

Addresses

Primary practice location

5670 Peachtree Dunwoody Rd
Suite 1280
Atlanta, GA 30342-1699

Mailing address

5670 Peachtree Dunwoody Rd
Suite 1280
Atlanta, GA 30342-1699
Phone (404) 257-1589

Other identifiers 5

IdentifierTypeStateIssuer
171WHOtherNCBCBS
9736865OtherNCAETNA
1570878OtherNCCIGNA
7413722MedicaidNC
SAN104MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000896 GA Practitioner - Qualified Audiologist 5991994139 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
AUD003057GAMDAudiologist
147.000630ILMDAudiologist
9089NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Concordia Anesthesiology, Inc PastSince Sep 1, 2018 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Audiologist Past Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Past Accepting new patients
Ear, Nose & Throat Associates of Savannah, PC Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1053621573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 1280",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421699",
            "telephone_number": "404-257-1589",
            "fax_number": "404-303-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 PEACHTREE DUNWOODY RD",
            "address_2": "SUITE 1280",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421699",
            "telephone_number": "404-257-1589",
            "fax_number": "404-303-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKRIDGE",
        "first_name": "KARIN",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD003057",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.000630",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "9089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "171WH",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9736865",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1570878",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7413722",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAN104",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.