NPIMap

Organization Active NPI

Bloom Creative Arts and Therapy Clinic

  • Early Intervention Provider Agency
  • Derby, NY
National Provider Identifier
1215467188
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
BLOOM CREATIVE ARTS AND THERAPY CLINIC
Practice address
7821 Erie Rd
Derby, NY 14047-9502
Phone
(716) 549-0585
NPI assigned
Jun 14, 2017
Last updated
Dec 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Megan Coltoniak
Title
Executive Director
Phone
(716) 982-5170

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

7821 Erie Rd
Derby, NY 14047-9502

Mailing address

73 Rovner PL
Hamburg, NY 14075-4205

National Provider Directory

National Provider Directory
Tax ID family
Bloom Creative Arts and Therapy Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1215467188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 ROVNER PL",
            "city": "HAMBURG",
            "state": "NY",
            "postal_code": "140754205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7821 ERIE RD",
            "city": "DERBY",
            "state": "NY",
            "postal_code": "140479502",
            "telephone_number": "716-549-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM CREATIVE ARTS AND THERAPY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-14",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "COLTONIAK",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-982-5170"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.