Individual provider Active NPI

Keisha Denise Lockhart, DNP APRN CNM

  • Pediatric Nurse Practitioner
  • Anderson, SC
National Provider Identifier
1669656468
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN25857RX Issued in SC
Practice address
102 Buford Ave Ste E
Anderson, SC 29621-3365
Phone
(864) 385-1485
Fax
(864) 448-1576
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN25857RX SC Primary

Addresses

Primary practice location

102 Buford Ave Ste E
Anderson, SC 29621-3365

Mailing address

102 Buford Ave Ste E
Anderson, SC 29621-3365
Phone (864) 385-1485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220920000382 SC Order and Referring Only - Other (Non-Physician) 4688059140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
APN25857RXSCMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1669656468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE STE E",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213365",
            "telephone_number": "864-385-1485",
            "fax_number": "864-448-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 BUFORD AVE STE E",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213365",
            "telephone_number": "864-385-1485",
            "fax_number": "864-448-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKHART",
        "first_name": "KEISHA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "DNP APRN CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "APN25857RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.