Active NPI
George Frank Broomfield Sr., C.N.A
- Nurse's Aide
- Indianapolis, IN
National Provider Identifier
1154562171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CNA9814475
- Practice address
- 3556 Rock Maple Dr
Indianapolis, IN 46235-3576 - Phone
- (317) 696-5380
- NPI assigned
- Mar 20, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CNA9814475 | IN | Primary |
Addresses
Primary practice location
3556 Rock Maple Dr
Indianapolis, IN 46235-3576
Mailing address
3556 Rock Maple Dr
Indianapolis, IN 46235-3576
Phone (317) 696-5380
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNA9814475 | IN | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237507200000",
"number": "1154562171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3556 ROCK MAPLE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462353576",
"telephone_number": "317-696-5380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3556 ROCK MAPLE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462353576",
"telephone_number": "317-696-5380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOMFIELD",
"first_name": "GEORGE",
"middle_name": "FRANK",
"name_suffix": "Sr.",
"credential": "C.N.A",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-20",
"last_updated": "2009-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "IN",
"license": "CNA9814475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.