Provider Demographics
NPI:1326894502
Name:WHEAT, SARA JO (MS, RDN)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:JO
Last Name:WHEAT
Suffix:
Gender:
Credentials:MS, RDN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JO
Other - Last Name:BARELA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7911 BARRAPORT DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-5669
Mailing Address - Country:US
Mailing Address - Phone:719-659-1138
Mailing Address - Fax:
Practice Address - Street 1:4090 BRIARGATE PKWY
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7815
Practice Address - Country:US
Practice Address - Phone:719-305-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered