Active NPI
Kathy McKnight Lockett, NNP
- Neonatal Nurse Practitioner
- Austell, GA
National Provider Identifier
1225036015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- RN114267
- Practice address
- 1790 Mulkey Rd
Austell, GA 30106-1122 - Phone
- (404) 277-0916
- Fax
- (770) 943-9106
- NPI assigned
- Jul 14, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | RN114267 | GA | Primary |
Addresses
Primary practice location
1790 Mulkey Rd
Austell, GA 30106-1122
Mailing address
3750 Cliff Crest Dr SE
Smyrna, GA 30080-5877
Phone (404) 277-0916
Other practice location 1
5901C Peachtree Dunwoody Rd NE
Suite C-65
Atlanta, GA 30328-5382
Phone (404) 252-9751
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00936218D | Medicaid | GA | |
| 00936218B | Medicaid | GA | |
| 00936218E | Medicaid | GA |
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 |
|---|---|---|---|
| RN114267 | GA | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neonatology Associates of Atlanta, P.C. | 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.
-
- Neonatal-Perinatal Medicine Physician
- Atlanta, GA
- NPI 1194822809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1225036015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3750 CLIFF CREST DR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300805877",
"telephone_number": "404-277-0916",
"fax_number": "770-943-9106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1790 MULKEY RD",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061122",
"telephone_number": "404-277-0916",
"fax_number": "770-943-9106"
}
],
"practiceLocations": [
{
"address_1": "5901C Peachtree Dunwoody Rd NE",
"address_2": "Suite C-65",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303285382",
"country_code": "US",
"telephone_number": "404-252-9751",
"fax_number": "678-990-5763",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOCKETT",
"first_name": "KATHY",
"middle_name": "MCKNIGHT",
"name_prefix": "Ms.",
"credential": "NNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-14",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "GA",
"license": "RN114267",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00936218D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00936218B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00936218E",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.