Genevieve E Broomfield, R.D, L.D., C.S.R.

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

LD001151 Issued in GA

Practice address

2758 Felton Dr
East Point, GA 30344-3604

Phone

(770) 356-9468

NPI assigned

Aug 7, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1740411776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 NEEDLETOP CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534315",
            "telephone_number": "770-356-9468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2758 FELTON DR",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443604",
            "telephone_number": "770-356-9468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMFIELD",
        "first_name": "GENEVIEVE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "R.D, L.D., C.S.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "LD001151",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "GA",
            "license": "LD001151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Renal Nutrition Registered Dietitian in East Point, GA
• Providers in East Point, GA by specialty
• Renal Nutrition Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.

Verify at the official NPI Registry.