NPIMap

Organization Active NPI

SJC Medical Group LLC

Doing business as Bloom Traditional Medicine

  • Clinic/Center
  • Kyle, TX
National Provider Identifier
1174230866
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SJC MEDICAL GROUP LLC
Doing business as
Bloom Traditional Medicine
Practice address
151 Kirkham Cir # B
Kyle, TX 78640-9703
Phone
(512) 893-3376
NPI assigned
Nov 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Dr. Jazmine M Collins, LACNPI 1386267102
Title
President/ Provider
Phone
(512) 893-3376

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

151 Kirkham Cir # B
Kyle, TX 78640-9703

Mailing address

151 Kirkham Cir # B
Kyle, TX 78640-9703
Phone (512) 893-3376

Other names 1

  • BLOOM TRADITIONAL MEDICINE Doing business as

National Provider Directory

National Provider Directory

Locations

151 Kirkham Cir
#B
Kyle, TX 78640
Phone (512) 893-3376

Practitioners & affiliated clinicians

Practitioners 2

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": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1174230866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KIRKHAM CIR # B",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786409703",
            "telephone_number": "512-893-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 KIRKHAM CIR # B",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786409703",
            "telephone_number": "512-893-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJC MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "JAZMINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ PROVIDER",
        "authorized_official_telephone_number": "512-893-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLOOM TRADITIONAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kyle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.