Individual provider Active NPI

Sara Allison O'Heron, MD

  • Family Medicine Physician
  • Peachtree City, GA
National Provider Identifier
1437163946
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
041632 Issued in GA
Practice address
1201 Georgian Park
Peachtree City, GA 30269-6972
Phone
(770) 631-4873
Fax
(770) 631-0684
NPI assigned
Jul 28, 2006
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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 041632 GA Primary

Addresses

Primary practice location

1201 Georgian Park
Peachtree City, GA 30269-6972

Mailing address

1201 Georgian Park
Peachtree City, GA 30269-6972
Phone (770) 631-4873

Other identifiers 1

IdentifierTypeStateIssuer
000730419ZMedicaidGA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041632GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeboat Medical Associates CurrentSince Apr 1, 2001 Accepting new patients
Lifeboat Medical Associates 2, LLC Past Accepting new patients

Locations

1201 Georgian Park
Peachtree Cty, GA 30269
Phone (770) 631-4873

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1437163946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GEORGIAN PARK",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696972",
            "telephone_number": "770-631-4873",
            "fax_number": "770-631-0684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 GEORGIAN PARK",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302696972",
            "telephone_number": "770-631-4873",
            "fax_number": "770-631-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'HERON",
        "first_name": "SARA",
        "middle_name": "ALLISON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "041632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000730419Z",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2012; 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.