MRS. SANDRA BERNETTE BROOMFIELD (NPI# 1760948434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760948434 |
| Entity Type | Individual |
| Full Name | MRS. SANDRA BERNETTE BROOMFIELD |
| Credential | NURSE PRACTITIONER |
| Practice Address |
575 1st St Macon GA 31201-2825 |
| Practice Telephone | 4787427566 |
| Practice Fax Number | 4787432804 |
| Mailing Telephone | 4787427566 |
| Mailing Fax Number | 4787432804 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2020-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN159851 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
575 1ST ST |
| City | MACON |
| State | GA |
| Zip Code | 31201-2825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174502314 | Peter J Bolan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 575 1st St, Macon, GA 31201-2825 | 2006-01-16 |
| 1366988818 | Haley Scruggs | Registered Nurse | 575 1st St, Macon, GA 31201-2825 | 2017-01-09 |
| 1861941775 | Latoia Samson | Physician Assistant | 575 1st St, Macon, GA 31201-2825 | 2016-10-04 |
| 1629438007 | Pamela Carty | Nurse Practitioner | 575 1st St, Macon, GA 31201-2825 | 2016-02-29 |
| 1790153450 | Rhonda Findley | Nurse Practitioner | 575 1st St, Macon, GA 31201-2825 | 2015-09-10 |
| 1801213467 | Jeffrey Brown | Physician Assistant | 575 1st St, Macon, GA 31201-2825 | 2014-03-20 |
| 1285068247 | Christy Rebecca Etheridge | Nurse Practitioner | 575 1st St, Macon, GA 31201-2825 | 2013-08-27 |
| 1295054245 | Melissa C. Mcphail | Nurse Practitioner | 575 1st St, Macon, GA 31201-2825 | 2010-05-28 |
| 1730408063 | Jared Lewis Jarrett | Nurse Practitioner | 575 1st St, Macon, GA 31201-2825 | 2010-05-26 |
| 1447437090 | Jason R Chapman | Surgery | 575 1st St, Macon, GA 31201-2825 | 2008-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730682048 | Qualivia Hawkins Cummings | Nurse Practitioner | 153 Heathwood Dr, Macon, GA 31206-5282 | 2018-03-13 |
| 1063952471 | Michelle Howard | Nurse Practitioner | 237 Coliseum Dr, Macon, GA 31217-3805 | 2017-03-03 |
| 1922486539 | Dwayne Taylor | Nurse Practitioner | 3708 Northside Dr Bldg B, Macon, GA 31210-2404 | 2015-05-14 |
| 1932278744 | Diane M. Craine | Nurse Practitioner | 4226 Hartley Bridge Rd, Suite 104, Macon, GA 31216-4115 | 2006-11-07 |
| 1538138813 | Sheryl Hall Winn | Nurse Practitioner | 100 College Station Dr, Macon, GA 31206-5100 | 2006-03-17 |
| 1760043608 | Emily Birdsong | Nurse Practitioner | 310 Hospital Dr Ste 205, Macon, GA 31217-8025 | 2019-06-21 |
| 1164995171 | Meredith Fleenor | Nurse Practitioner | 3356 Vineville Ave, Macon, GA 31204-2328 | 2019-01-03 |
| 1811429988 | James Shinholster Jr. | Nurse Practitioner | 777 Hemlock St, Msc10, Macon, GA 31201-2102 | 2017-03-29 |
| 1164973327 | Patricia Tarver | Nurse Practitioner | 840 Pine St, Suite 880, Macon, GA 31201-2100 | 2016-10-21 |
| 1235685959 | Lanita James | Nurse Practitioner | 770 Walnut St, Macon, GA 31201-7307 | 2016-09-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.