Individual provider Active NPI

Katherine Carol Richerson

  • Speech-Language Pathologist
  • Dacula, GA
National Provider Identifier
1114853082
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
PCET004542 Issued in GA
Practice address
3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907
Phone
(678) 377-9634
NPI assigned
Jun 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X PCET004542 GA Primary

Addresses

Primary practice location

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907

Mailing address

3615 Braselton Hwy Ste 103
Dacula, GA 30019-5907

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

NPI Registry JSON

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

{
    "created_epoch": "1781827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1114853082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 BRASELTON HWY STE 103",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195907",
            "telephone_number": "678-377-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHERSON",
        "first_name": "KATHERINE",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-19",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "PCET004542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.