Individual provider Active NPI

Kelly Ochu

  • Behavior Technician
  • Stone MTN, GA
National Provider Identifier
1356155394
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-24-331930 Issued in GA
Practice address
5140 Memorial Dr
Stone MTN, GA 30083-3111
Phone
(404) 983-0458
NPI assigned
Feb 1, 2025
Last updated
Feb 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-24-331930 GA Primary

Addresses

Primary practice location

5140 Memorial Dr
Stone MTN, GA 30083-3111

Mailing address

4045 Five Forks Trickum Rd SW # D17-124
Lilburn, GA 30047-2538

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

LicenseStateTypeSpecialty
RBT-24-331930GAMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Solid Foundation Christian Academy CurrentSince Feb 16, 2025 Accepting new patients

Locations

4045 Five Forks Trickum Rd SW
#D17124
Lilburn, GA 30047

5140 Memorial Dr
Stone Mtn, GA 30083
Phone (404) 983-0458

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, 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": "1738368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1356155394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 FIVE FORKS TRICKUM RD SW # D17-124",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5140 MEMORIAL DR",
            "city": "STONE MTN",
            "state": "GA",
            "postal_code": "300833111",
            "telephone_number": "404-983-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCHU",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-01",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "GA",
            "license": "RBT-24-331930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone MTN, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; 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.