Bloom Behavioral Health & Wellness, PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BLOOM BEHAVIORAL HEALTH & WELLNESS, PLLC

Practice address

200 S Rhodes St Ste E
West Memphis, AR 72301-4213

Phone

(662) 912-6024

Fax

(662) 265-9483

NPI assigned

Mar 2, 2023

Last updated

Mar 2, 2023By 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

Charledria McGee, DNP, PMHNP

Title

Owner, Provider

Phone

(901) 870-8624

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1083314629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 FALLINGWATER LN APT 102",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380167686",
            "telephone_number": "901-870-8624",
            "fax_number": "662-265-9483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S RHODES ST STE E",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014213",
            "telephone_number": "662-912-6024",
            "fax_number": "662-265-9483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM BEHAVIORAL HEALTH & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "CHARLEDRIA",
        "authorized_official_title_or_position": "OWNER, PROVIDER",
        "authorized_official_telephone_number": "901-870-8624",
        "authorized_official_credential": "DNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Billings, PTA
• Taylor Billingsley, OTA
• Erica Evette Billups, M.S. CCC-SLP
• Bio-Medical Applications of Arkansas, Inc. (Bma East Arkansas)
• Daniel L Bird, DDS, PA
• Latairricka//198 Bolden
• William D Bond, BS PHARMACIST
• Julianna Boskus, DDS
• Robert Blake Bowman, DDS
• Latoria Ann Boyland, PSYCH DNP

• Psychiatric/Mental Health Nurse Practitioner in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.