Individual provider Active NPI

Lakin Stephens

  • Physician Assistant
  • Smyrna, GA
National Provider Identifier
1336965359
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13768 Issued in GA
Practice address
3995 S Cobb Dr SE
Smyrna, GA 30080-6342
Phone
(770) 434-4567
NPI assigned
Nov 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13768 GA Primary

Addresses

Primary practice location

3995 S Cobb Dr SE
Smyrna, GA 30080-6342

Mailing address

3539 Mount Tabor Church Rd
Dallas, GA 30157-7102
Phone (912) 501-2690

Other practice location 1

709 Breedlove Dr
Monroe, GA 30655-2055
Phone (678) 635-3500

Other practice location 2

700 Breedlove Dr Ste C
Monroe, GA 30655-2064
Phone (706) 705-1687

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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1336965359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 MOUNT TABOR CHURCH RD",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301577102",
            "telephone_number": "912-501-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806342",
            "telephone_number": "770-434-4567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 Breedlove Dr",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552055",
            "country_code": "US",
            "telephone_number": "678-635-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Breedlove Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552064",
            "country_code": "US",
            "telephone_number": "706-705-1687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "LAKIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-25",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.