Individual provider Active NPI

Sara Lauren Peacock, MS, RD, LD

  • Registered Dietitian
  • Cincinnati, OH
National Provider Identifier
1851755680
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D1651 Issued in MS
Practice address
411 Oak St
Attn: Credentials
Cincinnati, OH 45219-2504
Phone
(513) 984-1800
Fax
(513) 984-4909
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1063048 MS
Registered Dietitian 133V00000X D1651 MS Primary

Addresses

Primary practice location

411 Oak St
Attn: Credentials
Cincinnati, OH 45219-2504

Mailing address

1614 Celia Dr
Wichita Falls, TX 76302-4130
Phone (601) 720-3194

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
Master of Science

State licenses

LicenseStateTypeSpecialty
1063048MSMDRegistered Dietitian
D1651MSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Medical Associates Past Accepting new patients
Sterling Adult Day Services Past 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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1851755680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1614 CELIA DR",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763024130",
            "telephone_number": "601-720-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 OAK ST",
            "address_2": "ATTN: CREDENTIALS",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452192504",
            "telephone_number": "513-984-1800",
            "fax_number": "513-984-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "SARA",
        "middle_name": "LAUREN",
        "credential": "MS, RD, LD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "1063048",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MS",
            "license": "D1651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.