Sandra Bernette Broomfield, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN159851 Issued in GA

Practice address

575 1St St
Macon, GA 31201-2825

Phone

(478) 742-7566

Fax

(478) 743-2804

NPI assigned

Feb 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA
• FHIR API: https://fhir4.healow.com/fhir/r4/HHAAAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgia Heart Physicians LLC

  • Cardiovascular Disease Physician
  • Macon, GA
  • NPI 1407994437
  Medicare reassignment NPD
• New Horizon Primary Care, LLC

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1770794851
  Medicare reassignment NPD
• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment NPD
• Macon Electrophysiology Associates

  • Clinical Cardiac Electrophysiology Physician
  • Macon, GA
  • NPI 1306923495
  NPD (past)

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1760948434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012825",
            "telephone_number": "478-742-7566",
            "fax_number": "478-743-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 1ST ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012825",
            "telephone_number": "478-742-7566",
            "fax_number": "478-743-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOMFIELD",
        "first_name": "SANDRA",
        "middle_name": "BERNETTE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-18",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN159851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tuwanna Yvette Brooks, APRN
• Virginia Shealy Brooks, PT, DPT
• William P Brooks, M.D.
• William White Brooks, MD
• Sharon K Broom, ARNP
• Eboni Grace Broussard, MA, NCC
• Corretta Stephanie Brown-Spencer, DDS
• Angela Gaynell Brown
• Brandon Brown
• Brittney Nicole Brown

• Adult Health Nurse Practitioner in Macon, GA
• Providers in Macon, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.