Individual provider Active NPI

Heather Ronelle Bloomfield, NP

  • Nurse Practitioner
  • Crown Point, IN
National Provider Identifier
1083197131
Registry record updated Aug 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71008334A Issued in IN
Practice address
2100 N Main St Ste 304
Crown Point, IN 46307-1877
Phone
(574) 546-1900
Fax
(574) 546-1999
NPI assigned
Sep 13, 2018
Last updated
Aug 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71008334A IN Primary
Adult Health Nurse Practitioner 363LA2200X 71008334A IN
Gerontology Nurse Practitioner 363LG0600X 71008334A IN

Addresses

Primary practice location

2100 N Main St Ste 304
Crown Point, IN 46307-1877

Mailing address

PO Box 10299
Fort Wayne, IN 46851-0299
Phone (574) 546-1900

Other practice location 1

44 S Souder Ave
Columbus, OH 43222-1539
Phone (574) 546-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.06 of 100Reported as group
Quality
80.07
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71008334AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Psychiatric Services LLC CurrentSince Aug 3, 2025 Accepting new patients

Locations

1025 W Rudisill Blvd
Ste 229
Fort Wayne, IN 46807
Phone (260) 433-8583

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1083197131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10299",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468510299",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N MAIN ST STE 304",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071877",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 S Souder Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432221539",
            "country_code": "US",
            "telephone_number": "574-546-1900",
            "fax_number": "574-546-1999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMFIELD",
        "first_name": "HEATHER",
        "middle_name": "RONELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71008334A",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71008334A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71008334A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

Verify at the official NPI Registry.