Individual provider Active NPI

Alicia Gail Heron, M.D.

  • Family Medicine Physician
  • Alexandria, VA
National Provider Identifier
1417018607
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101030856 Issued in VA
Practice address
321 S Patrick St
Alexandria, VA 22314-3534
Phone
(703) 549-2626
Fax
(703) 299-5080
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101030856 VA Primary

Addresses

Primary practice location

321 S Patrick St
Alexandria, VA 22314-3534

Mailing address

321 S Patrick St
Heron Medical Center/Smart Lipo Center
Alexandria, VA 22314-3534
Phone (703) 549-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101030856VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stafford Urgent Care, Inc. Past Accepting new patients
Stafford Primary Care Associates, Inc. PastSince Mar 1, 2007 Accepting new patients

Organizations & group practices 2

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1417018607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S PATRICK ST",
            "address_2": "HERON MEDICAL CENTER/SMART LIPO CENTER",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223143534",
            "telephone_number": "703-549-2626",
            "fax_number": "703-299-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S PATRICK ST",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223143534",
            "telephone_number": "703-549-2626",
            "fax_number": "703-299-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERON",
        "first_name": "ALICIA",
        "middle_name": "GAIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101030856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.