Orville A Broomfield, CRNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

RN2729162 Issued in FL

Practice address

400 Health Park Blvd
St Augustine, FL 32086

Phone

(904) 824-4990

Fax

(904) 824-2226

NPI assigned

Oct 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1689853285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMFIELD",
        "first_name": "ORVILLE",
        "middle_name": "A",
        "credential": "CRNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-31",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "RN2729162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312246800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natallia Brooks Jones
• Alison Brooks
• Dallas Brooks, RBT
• Dayzha Brooks
• Penny Ruth Brooks, FNP-BC
• Bethany Ann Brown, ARNP
• Brandon Brown, P.T.
• Comelia J Brown, RN
• Jacqueline B. Brown, PH.D.
• Joshua Jay Brown, RPH

• Registered Nurse First Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Registered Nurse First Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.