Bloom Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8969 Issued in AZ

Legal business name

BLOOM PHYSICAL THERAPY, LLC

Practice address

3035 S Ellsworth Rd Ste 128
Mesa, AZ 85212-2161

Phone

(480) 357-6500

NPI assigned

Nov 19, 2016

Last updated

Nov 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric BloomNPI 1730480666

Title

Owner

Phone

(808) 224-5802

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Eric James Bloom, DPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1730480666
  Authorized official Same address or phone
• Todd Waterkotte, DPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1427064575
  NPD (past)

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

{
    "created_epoch": "1479513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479513600000",
    "number": "1003359225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 S ELLSWORTH RD STE 128",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S ELLSWORTH RD STE 128",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122161",
            "telephone_number": "480-357-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-19",
        "last_updated": "2016-11-19",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-224-5802"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "8969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Marie Bliss-Lefebvre, LPC
• Blissful Moment Counseling
• Hilary Jean Blommel, PT, DPT
• Bloom
• Bloom From Within Therapy, LLC
• Eric James Bloom, DPT
• Rosemary Bloom, PA
• Beth Ann Bloomfield-Fox, LPC
• Molly Ann Bloomfield, M.S., CF-SLP
• Blossom Health Services LLC (Today is tomorrow behavioral health services)

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2016; 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.