Jeannie Blom MD PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

041517 Issued in GA

Legal business name

JEANNIE BLOM MD PC

Practice address

2722 N. Decatur
Decatur, GA 30033

Phone

(404) 849-3443

Fax

(404) 467-1004

NPI assigned

Oct 13, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Jeannie M Blom, M.D.

Title

Ceo

Phone

(404) 849-3443

Specialties & licenses 1

Addresses

Other names 1

• Jeannie-In-A-Bottle Doing business as

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1144530155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190218",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311190218",
            "telephone_number": "866-214-8600",
            "fax_number": "678-888-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 N. DECATUR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30033",
            "telephone_number": "404-849-3443",
            "fax_number": "404-467-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEANNIE BLOM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "BLOM",
        "authorized_official_first_name": "JEANNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-849-3443",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "041517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeannie-In-A-Bottle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kshama Jawalekar, M.D.
• Jay C. Fisher DMD PC
• Bhanumathi Jayakumar, ANP-C
• Jayray Urodynamics LLC
• JD Wallace Enterprises
• Charlene Andrea Jeanpierre, RN
• Jeavaat Medical LLC
• Jedidiah'S Investment Holdings, Inc.
• Jeff a Traub, MD, PC
• Jeffrey K Waters D.M.D., P.C

• Physical Medicine & Rehabilitation Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.