Active NPI
Mary Ciporah Blumenfeld
- Pediatrics Physician
- Atlanta, GA
National Provider Identifier
1134860638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 104143
- Practice address
- 2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117 - Phone
- (302) 382-9023
- NPI assigned
- Apr 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 104143 | GA | Primary |
Addresses
Primary practice location
2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Mailing address
2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone (302) 382-9023
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104143 | GA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759017600000",
"number": "1134860638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2220 N DRUID HILLS RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303293117",
"telephone_number": "302-382-9023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2220 N DRUID HILLS RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303293117",
"telephone_number": "302-382-9023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENFELD",
"first_name": "MARY",
"middle_name": "CIPORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-06",
"last_updated": "2025-09-28",
"certification_date": "2025-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "104143",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.