Shelley Erline Bloom, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21841 Issued in CA

Practice address

420 I St
Suite 7
Sacramento, CA 95814-2314

Phone

(916) 441-2811

NPI assigned

Sep 5, 2012

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1255680393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 I ST",
            "address_2": "SUITE 7",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142314",
            "telephone_number": "916-441-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 I ST",
            "address_2": "SUITE 7",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958142314",
            "telephone_number": "916-441-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SHELLEY",
        "middle_name": "ERLINE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom and Bee LLC
• Bloom Care Network, Inc.
• Bloom Ink Collective, LLC
• Andrew Jason Bloom, PA-C
• Evan D. Bloom, MD
• Stewart Richard Bloom, M.S.W.
• Blooming With Iyanna
• Hanna Bloomquist
• Jett Paul Blos
• Sharon A Blosk, M.D.

• Family Nurse Practitioner in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.