OrganizationActive
Golden Bloom Phrams Inc
NPI 1962007252 · Exclusive Provider Organization · Conyers, GA
Provider details
- NPI number
- 1962007252
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Jessica Lane, President(770) 633-8550
Specialties & taxonomies
Managed Care Organizations
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1172 Old Salem Rd Se
Conyers, GA 30094-5944
Phone: (770) 633-8550
Street-level locationGet directions
Mailing address
1172 Old Salem Rd Se
Conyers, GA 30094-5944
Registry dates
- Enumerated
- 2020-12-03
- Last updated
- 2020-12-03
- Certified
- 2020-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.