Individual provider Active NPI

Kristen Nicole Lockard

  • Speech-Language Pathologist
  • Suwanee, GA
National Provider Identifier
1851918403
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
5050 Research CT
Suwanee, GA 30024-6606
Phone
(678) 749-7600
NPI assigned
Jun 30, 2020
Reactivated
Oct 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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 GA Primary

Addresses

Primary practice location

5050 Research CT
Suwanee, GA 30024-6606

Mailing address

1515 Huntingdon Chase
Sandy Springs, GA 30350-4976
Phone (770) 329-9165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113001410 GA Practitioner - Qualified Speech Language Pathologist 0143758573

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Leap Language and Developmental Services Speech-Language Pathologist CurrentSince Oct 1, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1851918403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 HUNTINGDON CHASE",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303504976",
            "telephone_number": "770-329-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 RESEARCH CT",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246606",
            "telephone_number": "678-749-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKARD",
        "first_name": "KRISTEN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "deactivation_date": "2022-09-23",
        "reactivation_date": "2022-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.