Individual provider Active NPI

Melissa Ann Bloomfield, LPN

  • Licensed Practical Nurse
  • Waverly, OH
National Provider Identifier
1386967487
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN. 127850 IV Issued in OH
Practice address
180 Ryan Dr
Waverly, OH 45690-9300
Phone
(740) 941-8737
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN. 127850 IV OH Primary

Addresses

Primary practice location

180 Ryan Dr
Waverly, OH 45690-9300

Mailing address

180 Ryan Dr
Waverly, OH 45690-9300
Phone (740) 941-8737

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

LicenseStateTypeSpecialty
PN. 127850 IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1386967487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 RYAN DR",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909300",
            "telephone_number": "740-941-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 RYAN DR",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456909300",
            "telephone_number": "740-941-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMFIELD",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN. 127850       IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.