Active NPI
James D. Broome Jr., LCSW, LISW, ACSW
- Clinical Social Worker
- Decatur, GA
National Provider Identifier
1568490498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW004156
- Practice address
- 1670 Clairmont Rd
Room 5C105
Decatur, GA 30033-4004 - Phone
- (404) 321-6111
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW004156 | GA | Primary |
| Clinical Social Worker | 1041C0700X | LISW #02931 | IA |
Addresses
Primary practice location
1670 Clairmont Rd
Room 5C105
Decatur, GA 30033-4004
Mailing address
1670 Clairmont Rd
Atlanta VA Hospital
Decatur, GA 30033-4004
Phone (404) 321-6111
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 |
|---|---|---|---|
| CSW004156 | GA | MD | Clinical Social Worker |
| LISW #02931 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363737600000",
"number": "1568490498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1670 CLAIRMONT RD",
"address_2": "ATLANTA VA HOSPITAL",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334004",
"telephone_number": "404-321-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 CLAIRMONT RD",
"address_2": "ROOM 5C105",
"city": "DECATUR",
"state": "GA",
"postal_code": "300334004",
"telephone_number": "404-321-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROOME",
"first_name": "JAMES",
"middle_name": "D.",
"name_suffix": "Jr.",
"credential": "LCSW, LISW, ACSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2013-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW004156",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "LISW #02931",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.