Individual provider Active NPI

Heather Sales, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1740414275
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9104734 Issued in FL
Practice address
2000 N Forsyth Rd
Orlando, FL 32807-5261
Phone
(407) 322-8645
Fax
(321) 275-0867
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9104734 FL Primary

Addresses

Primary practice location

2000 N Forsyth Rd
Orlando, FL 32807-5261

Mailing address

4930 E. Lake Mary Blvd.
Sanford, FL 32377-5003
Phone (407) 322-8645

Other identifiers 3

IdentifierTypeStateIssuer
541508OtherFLWELLCARE
001924000MedicaidFL
01353503OtherFLAMERIGROUP

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
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1740414275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E. LAKE MARY BLVD.",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "323775003",
            "telephone_number": "407-322-8645",
            "fax_number": "407-330-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N FORSYTH RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328075261",
            "telephone_number": "407-322-8645",
            "fax_number": "321-275-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALES",
        "first_name": "HEATHER",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "541508",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001924000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01353503",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.