Healing Oaks LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

HEALING OAKS LLC

Practice address

203 Oakside LN Ste C
Canton, GA 30114-6407

Phone

(770) 604-1930

Fax

(770) 604-1929

NPI assigned

Mar 22, 2021

Organization subpart

No

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

Authorized official

Name

Sheryl B Vickery, MDNPI 1538226220

Title

Owner/Manager

Phone

(770) 378-0328

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sheryl B Vickery, M.D.

  • Family Medicine Physician
  • Canton, GA
  • NPI 1538226220
  Medicare reassignment NPD Authorized official
• Meera Thirumal

  • Family Nurse Practitioner
  • Canton, GA
  • NPI 1629759071
  NPD

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1649856493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5554",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301140290",
            "telephone_number": "770-378-0328",
            "fax_number": "770-604-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 OAKSIDE LN STE C",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146407",
            "telephone_number": "770-604-1930",
            "fax_number": "770-604-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING OAKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "VICKERY",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "770-378-0328",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "773092643F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny Sue Haynes, CADC II
• Robert Taulbee Hazel, RN
• Deborah Morris Hazen
• Jennifer Head, MS, CCC-SLP
• Lucy E Heagy
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• Kimberly Heard, R. PH.
• Heart and Soul Pediatrics LLC
• Heartland Dental Care of Georgia

• Primary Care Clinic/Center in Canton, GA
• Providers in Canton, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.