Heather Dawn Macleod Lawder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA00498 Issued in GA

Practice address

11190 Medlock Bridge Rd
Johns Creek, GA 30097-2578

Phone

(678) 464-7162

NPI assigned

Dec 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1518677384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12775 OAK FALLS DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300093062",
            "telephone_number": "770-309-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11190 MEDLOCK BRIDGE RD",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972578",
            "telephone_number": "678-464-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWDER",
        "first_name": "HEATHER",
        "middle_name": "DAWN MACLEOD",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA00498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratory Corporation of America Holdings
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• Davinci Le, PHARMD
• Diana Lee, PHARMD
• Jonai Lee
• Jong Won Lee, D.C.

• Physical Therapy Assistant in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.