Individual provider Active NPI

Lakeeta Ladson, MA, CCC-SLP

  • Speech-Language Pathologist
  • Sumter, SC
National Provider Identifier
1205990470
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3488 Issued in SC
Practice address
444A Broad St
Sumter, SC 29150-4157
Phone
(704) 681-1110
Fax
(704) 749-8540
NPI assigned
Dec 21, 2006
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3488 SC Primary
Speech-Language Pathologist 235Z00000X 9366 NC

Addresses

Primary practice location

444A Broad St
Sumter, SC 29150-4157

Mailing address

10 S 9TH St
Ste 4
Noblesville, IN 46060-2631
Phone (765) 524-3946

Other practice location 1

8130 Chrisbry Ln
Charlotte, NC 28215-8583
Phone (704) 517-5817

Other identifiers 1

IdentifierTypeStateIssuer
SAN033MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141126001967 NC Practitioner - Qualified Speech Language Pathologist 9739401845 Reassigns benefits to 1 organization
I20201119002613 SC Practitioner - Qualified Speech Language Pathologist 9739401845 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9366NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Nov 1, 2020 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Dec 5, 2022 Accepting new patients
Complete Speech & Wellness, LLC Speech-Language Pathologist Current Accepting new patients
Creative Health Care Management, LLC Speech-Language Pathologist CurrentSince Nov 1, 2020 Accepting new patients
Complete Speech & Wellness, LLC Speech-Language Pathologist Current Accepting new patients
Complete Speech Therapy and Wellness PLLC Speech-Language Pathologist Current Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Dec 5, 2022 Accepting new patients

Locations

10 S 9th St
Ste 4
Noblesville, IN 46060

303 N Hurstbourne Pkwy
Ste 200
Louisville, KY 40222
Phone (502) 213-7572

4968 Milestone Ave
Kannapolis, NC 28081
Phone (704) 323-8222

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

2563 N Fraser St
Georgetown, SC 29440
Phone (843) 492-4674

11951 Grandhaven Dr
Murrells Inlet, SC 29576
Phone (843) 357-0200

2065 McCrays Mill Rd
Sumter, SC 29154
Phone (502) 213-7575

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1205990470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S 9TH ST",
            "address_2": "STE 4",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460602631",
            "telephone_number": "765-524-3946",
            "fax_number": "317-708-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444A BROAD ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504157",
            "telephone_number": "704-681-1110",
            "fax_number": "704-749-8540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8130 Chrisbry Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282158583",
            "country_code": "US",
            "telephone_number": "704-517-5817",
            "fax_number": "704-517-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LADSON",
        "first_name": "LAKEETA",
        "name_prefix": "Ms.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3488",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9366",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SAN033",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumter, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.