NPIMap

Organization Active NPI

Bloom Pediatric Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Litchfield, CT
National Provider Identifier
1114818002
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BLOOM PEDIATRIC THERAPY, PLLC
Practice address
17 Commons Dr Unit 6
Litchfield, CT 06759
Phone
(203) 417-5864
NPI assigned
Jul 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Authorized official

Name
Bianca Bolduc, DPTNPI 1275075285
Title
Owner
Phone
(203) 417-5864

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
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

17 Commons Dr Unit 6
Litchfield, CT 06759

Mailing address

43 Maple View TRL
Litchfield, CT 06759-2125
Phone (203) 417-5864

National Provider Directory

National Provider Directory

Locations

17 Commons Dr
Unit 6
Litchfield, CT 06759
Phone (203) 417-5864

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1752105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1114818002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 MAPLE VIEW TRL",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "067592125",
            "telephone_number": "203-417-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 COMMONS DR UNIT 6",
            "city": "LITCHFIELD",
            "state": "CT",
            "postal_code": "06759",
            "telephone_number": "203-417-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM PEDIATRIC THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-10",
        "last_updated": "2025-07-10",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "BOLDUC",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-417-5864",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.