Sandra Herzwurm, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

031945 Issued in GA

Practice address

411 Town Park Blvd
Evans, GA 30809-3089

Phone

(706) 854-2500

Fax

(706) 854-2559

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: sandra.herzwurm.1@14928.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14928/brand/1/csg/1/fhir/r4

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.

• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620
  NPD (past)
• Melissa Jadick

  • Pediatrics Physician
  • Augusta, GA
  • NPI 1013927946
  NPD (past)
• Pediatric Partners of Augusta, LLC

  • Pediatrics Physician
  • Evans, GA
  • NPI 1417064924
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1407850845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 1758",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093089",
            "telephone_number": "706-854-2500",
            "fax_number": "706-854-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 TOWN PARK BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093089",
            "telephone_number": "706-854-2500",
            "fax_number": "706-854-2559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZWURM",
        "first_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "031945",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "031945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000685506D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephan M Henson, PA
• Here to Hear Mental Health & Wellness LLC
• Donnetta L Herold, RPH
• Laura Beth Herren, LMT
• Shari Ann Herzberg, RBT
• Diana Hess, ED.D
• Donna Michelle Hester
• Julie Palbykin Hicks, M.D.
• Ashley Hill
• Emerald Hill

• Pediatrics Physician in Evans, GA
• Providers in Evans, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.