Active NPI
Roberta A Bloomfield
- Family Nurse Practitioner
- Marietta, GA
National Provider Identifier
1881333581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 169167
- Practice address
- 3440 Velvet Creek Dr SW
Marietta, GA 30008-7627 - Phone
- (770) 431-3953
- NPI assigned
- Jun 1, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 169167 | GA | Primary |
Addresses
Primary practice location
3440 Velvet Creek Dr SW
Marietta, GA 30008-7627
Mailing address
3440 Velvet Creek Dr SW
Marietta, GA 30008-7627
Phone (770) 431-1888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 169167 | GA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654128000000",
"number": "1881333581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 VELVET CREEK DR SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300087627",
"telephone_number": "770-431-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 VELVET CREEK DR SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300087627",
"telephone_number": "770-431-3953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOMFIELD",
"first_name": "ROBERTA",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-01",
"last_updated": "2022-06-02",
"certification_date": "2022-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "169167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.