NPIMap

Organization Active NPI

Bloom Pediatrics PC

  • Pediatrics Physician
  • Birmingham, MI
National Provider Identifier
1043364680
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
JE031896 Issued in MI
Legal business name
BLOOM PEDIATRICS PC
Practice address
2055 E 14 Mile Road
Birmingham, MI 48009
Phone
(248) 645-1740
Fax
(248) 645-5304
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Authorized official

Name
Katherine Schafer, D.O.NPI 1932396264
Title
Owner
Phone
(248) 835-5064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X JE031896 MI Primary

Addresses

Primary practice location

2055 E 14 Mile Road
Birmingham, MI 48009

Mailing address

2055 E 14 Mile Road
Birmingham, MI 48009
Phone (248) 645-1740

Other names 1

  • Eastman, Wozniak, Groebe Pediatrics P.C. Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0362833Bloom Pediatrics2055 E 14 Mile Road, Birmingham, MI 48009ComplianceAug 18, 2027

National Provider Directory

National Provider Directory

Locations

2055 E 14 Mile Rd
Birmingham, MI 48009
Phone (248) 645-1740

2055 E 14 Mile Rd
Ste 120
Birmingham, MI 48009
Phone (248) 645-1740

28628 Northwestern Hwy Ste 100
Southfield, MI 48034

28625 Northwestern Hwy
Southfield, MI 48034
Phone (248) 350-3190

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613433600000",
    "number": "1043364680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E 14 MILE ROAD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "48009",
            "telephone_number": "248-645-1740",
            "fax_number": "248-645-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E 14 MILE ROAD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "48009",
            "telephone_number": "248-645-1740",
            "fax_number": "248-645-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "SCHAFER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-835-5064",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "JE031896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastman, Wozniak, Groebe Pediatrics P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.