Olivia Nilda Blom

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

8652 Issued in ID

Practice address

5251 E Exchange Way
Nampa, ID 83687-5507

Phone

(208) 466-9642

Fax

(208) 466-9104

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372
  NPD

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1245918549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5251 E EXCHANGE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875507",
            "telephone_number": "208-466-9642",
            "fax_number": "208-466-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5251 E EXCHANGE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875507",
            "telephone_number": "208-466-9642",
            "fax_number": "208-466-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "OLIVIA",
        "middle_name": "NILDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "8652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callie Rose Blair, D.O.
• Michael PR Blair, FNP-C
• Teresa L Blair, CNM - WHNP
• Leah Janine Blake
• Amanda Rose Bledsoe, FNP-C
• Bloom Coordination, LLC
• Bloom Idaho LLC
• Blossom Therapy LLC
• Blue Birds Specialty Services LLC
• Blue Sky Behavioral Health

• Physical Medicine & Rehabilitation Physician in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Medicine & Rehabilitation Physician in Idaho

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