Individual provider Active NPI

Kahleel Locke

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, GA
National Provider Identifier
1396156188
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP297748 Issued in GA
Practice address
70 Lafayettes LNDG
Jonesboro, GA 30238-6702
Phone
(646) 752-8144
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 754102 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407106 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP297748 GA Primary
Registered Nurse 163W00000X RN297748 GA

Addresses

Primary practice location

70 Lafayettes LNDG
Jonesboro, GA 30238-6702

Mailing address

1415 Highway 85 N Ste 310-379
Fayetteville, GA 30214-7738
Phone (646) 752-8144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

New York, NY 10016
Phone (347) 433-7087

136 Madison Ave
FL 6
New York, NY 10016-6763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN297748GAMDRegistered Nurse
754102NYMDRegistered Nurse
NP297748GAMDPsychiatric/Mental Health Nurse Practitioner
407106NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1396156188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HIGHWAY 85 N STE 310-379",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147738",
            "telephone_number": "646-752-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 LAFAYETTES LNDG",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302386702",
            "telephone_number": "646-752-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKE",
        "first_name": "KAHLEEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "754102",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407106",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "NP297748",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN297748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.