Individual provider Active NPI

Sondra Diane Heaston, NP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1104916956
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
217181-8900 Issued in UT
Practice address
3215 Valley St
Salt Lake City, UT 84109-4217
Phone
(801) 466-3102
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 217181-4405 UT
Family Nurse Practitioner 363LF0000X 217181-8900 UT Primary

Addresses

Primary practice location

3215 Valley St
Salt Lake City, UT 84109-4217

Mailing address

1481 N 1450 E
Provo, UT 84604-3714
Phone (801) 377-1298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090331000608 UT Practitioner - Nurse Practitioner 7315004652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Family MedicalGroup PAC ID 7416197785, 84 clinicians

Practice addresses (Care Compare)

830 N 2000
Pleasant Grove, UT 84062-4047
Phone (801) 756-3511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Medical - Saratoga Springs CurrentSince Jul 1, 2013 Accepting new patients
Premier Family Medical Current Accepting new patients
Premier Family Medical - City Center CurrentSince Jul 1, 2013 Accepting new patients

Locations

226 N 1100 E
American Fork, UT 84003
Phone (801) 855-3840

3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 443-1184

3000 N Triumph Blvd
Ste 220
Lehi, UT 84043
Phone (801) 642-2990

680 E Main St
Lehi, UT 84043
Phone (801) 766-0606

275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333

830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511

Organizations & group practices 3

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104916956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 N 1450 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043714",
            "telephone_number": "801-377-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 VALLEY ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841094217",
            "telephone_number": "801-466-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEASTON",
        "first_name": "SONDRA",
        "middle_name": "DIANE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "217181-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "217181-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.