Jill C Bloomer, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8477 Issued in MN

Practice address

101 W 2ND St
Duluth, MN 55802-2086

Phone

(907) 854-6005

NPI assigned

May 14, 2020

Last updated

Sep 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Webmed LLCGroup PAC ID 2163767286, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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

• Webmed LLC

  dba WebMed Mental Health Services

  • Psychiatry Physician
  • Duluth, MN
  • NPI 1073021036

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1073135869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022086",
            "telephone_number": "907-854-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022086",
            "telephone_number": "907-854-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "JILL",
        "middle_name": "C",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8477",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "308022",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blink Optometry, LLC
• David Jon Blomberg, MD
• Bloom Behavioral Health LLC
• Stephen Leonard Bloom
• Zomi Louise Bloom
• Britta Natalie Bloomquist, LGSW
• Mark Nicholas Bloss, OTR/L
• Bluestone Dental PLLC
• Bluestone Oral and Maxillofacial Surgery, P.a.
• Melanie Ann Bluth, DDS

• Psychiatric/Mental Health Nurse Practitioner in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; 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.
• 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.