Bloom Idaho LLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

BLOOM IDAHO LLC

Practice address

3185 E Ustick Rd
Meridian, ID 83646

Phone

(208) 296-7100

NPI assigned

Mar 17, 2021

Organization subpart

No

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

Authorized official

Name

Spencer Smith

Title

Ceo

Phone

(208) 853-3000

Specialties & licenses 1

Addresses

Other names 1

• AFC Urgent Care Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Bloom Idaho LLC

  • Multi-Specialty Clinic/Center
  • Garden City, ID
  • NPI 1679134126

  Member Of

  NPD member

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1104401488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5943",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234710943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3185 E USTICK RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83646",
            "telephone_number": "208-296-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-853-3000"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFC Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn Blaisdell, MS OTR/L
• Lloyd W. Blake, MD
• Sheila Marie Blewett, LPC
• Marijke Blokker
• Blood on the Run Inc.
• Blue Creek Endodontics
• Blue Meadow Counseling
• Blue MTN Chiropractic
• Bluebird Home Care, LLC
• Bluebird Home Health, LLC

• Urgent Care Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Urgent Care Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.