Individual provider Active NPI

Kathy Jo Bloemker, PT, MSPT

  • Physical Therapist
  • Omaha, NE
National Provider Identifier
1174029680
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1285 Issued in NE
Practice address
2510 S 140TH St
Omaha, NE 68144-2339
Phone
(402) 618-3320
Fax
(402) 913-3102
NPI assigned
Apr 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10608 MN
Physical Therapist 225100000X 1285 NE Primary

Addresses

Primary practice location

2510 S 140TH St
Omaha, NE 68144-2339

Mailing address

2510 S 140TH St
Omaha, NE 68144-2339
Phone (402) 618-3320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241031002755 NE Practitioner - Physical Therapist in Private Practice 8325302037

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1174029680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 S 140TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442339",
            "telephone_number": "402-618-3320",
            "fax_number": "402-913-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 S 140TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681442339",
            "telephone_number": "402-618-3320",
            "fax_number": "402-913-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOEMKER",
        "first_name": "KATHY",
        "middle_name": "JO",
        "credential": "PT, MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "10608",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "1285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.