Rosemary Kay Bloom, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

73617-030 Issued in WI

Practice address

5118 Lakewind Drive
Butte Des Morts, WI 54927

Phone

(920) 859-0042

Fax

(920) 859-0042

NPI assigned

Mar 27, 2008

Last updated

Mar 27, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Rosemary Kay Bloom Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1033381306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 377",
            "city": "BUTTE DES MORTS",
            "state": "WI",
            "postal_code": "549270377",
            "telephone_number": "920-859-0042",
            "fax_number": "920-859-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5118 LAKEWIND DRIVE",
            "city": "BUTTE DES MORTS",
            "state": "WI",
            "postal_code": "54927",
            "telephone_number": "920-859-0042",
            "fax_number": "920-859-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "ROSEMARY",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "73617-030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38229100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARY",
            "last_name": "BLOOM",
            "middle_name": "KAY",
            "prefix": "MS.",
            "credential": "R.N.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gail I. R. Johnson

• Registered Nurse in Butte Des Morts, WI
• Providers in Butte Des Morts, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.