Individual provider Active NPI

Kristen Wyatt

  • Speech-Language Pathologist
  • Carrollton, GA
National Provider Identifier
1346135415
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
150 Cottage LN
Carrollton, GA 30117-6200
Phone
(578) 547-0226
NPI assigned
Jun 10, 2025
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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 NU Primary

Addresses

Primary practice location

150 Cottage LN
Carrollton, GA 30117-6200

Mailing address

1860 Atkinson Rd
Lawrenceville, GA 30043-5065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250811001441 GA Practitioner - Qualified Speech Language Pathologist 0648778555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
RWW Senior Living Outpatient Rehab Services, LLC CurrentSince Jun 16, 2025 Accepting new patients
RWW Senior Living Outpatient Rehab Services, LLC CurrentSince Jun 16, 2025 Accepting new patients

Locations

150 Cottage Ln
Carrollton, GA 30117
Phone (770) 830-8857

1860 Atkinson Rd
Lawrenceville, GA 30043
Phone (706) 948-2773

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

Organizations & group practices 2

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": "1749513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1346135415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 ATKINSON RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 COTTAGE LN",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301176200",
            "telephone_number": "578-547-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYATT",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.