Bloom Speech Therapy Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLOOM SPEECH THERAPY SERVICES, LLC

Practice address

200 W 1St St Ste 101
Farmington, MO 63640-2521

Phone

(573) 327-1510

NPI assigned

Oct 24, 2023

Last updated

Oct 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy Diana Smith, MA, CCC-SLP

Title

Speech-Language Pathologist

Phone

(573) 327-1510

Specialties & licenses 1

Addresses

Other names 1

• Bloom Speech Therapy Services Other name

Locations

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1225800105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S HARDING ST",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636012956",
            "telephone_number": "573-327-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 1ST ST STE 101",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636402521",
            "telephone_number": "573-327-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM SPEECH THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "DIANA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "573-327-1510",
        "authorized_official_credential": "MA, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloom Speech Therapy Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Emily Marie Black
• Kimberly Marie Black, LCSW
• Laurie Lee Black, LCSW
• Nicole Black
• Diana Ruth Blocker
• Rebecca Jean Bloom, B.S.ED.
• Adam Blum
• Jordan Celia Blum, B.S
• Kevin Boatright
• Carrie Bockenkamp

• Speech-Language Pathologist in Farmington, MO
• Providers in Farmington, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.