Healthcare Provider Details

I. General information

NPI: 1437076940
Provider Name (Legal Business Name): SARAH BOMERS RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7859 W 42ND AVE
WHEAT RIDGE CO
80033-4521
US

IV. Provider business mailing address

7859 W 42ND AVE
WHEAT RIDGE CO
80033-4521
US

V. Phone/Fax

Practice location:
  • Phone: 616-422-9675
  • Fax:
Mailing address:
  • Phone: 616-422-9675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86471995
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: