Cherilee C Bloom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3510 Issued in ID

Practice address

815 West Canfield Avenue
Coeur Dalene, ID 83815

Phone

(208) 762-2544

Fax

(208) 762-9563

NPI assigned

Aug 30, 2006

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

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cherilee C Bloom DDS PLLC

  • Dentist
  • Coeur D Alene, ID
  • NPI 1083873939
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1043320179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 WEST CANFIELD AVENUE",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83815",
            "telephone_number": "208-762-2544",
            "fax_number": "208-762-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 WEST CANFIELD AVENUE",
            "city": "COEUR DALENE",
            "state": "ID",
            "postal_code": "83815",
            "telephone_number": "208-762-2544",
            "fax_number": "208-762-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "CHERILEE",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne D Baures, RPH
• James W Behrens, DPT
• Noelle Marie Beierle, APRN, NP-C
• BHG Lxxxvii, LLC
• Gary Bills, DDS
• Barbara Campbell, RPH
• Stephanie Coates, LMSW
• Evelyn Borromeo Considine, NP
• Albert Allen Crook, DO
• Cultivation, LLC

• All providers in Coeur Dalene, ID
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.