Jason Corey Bloomer, MSN, RN, CCRN, FANAI

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

RN-80349 Issued in NM

Practice address

502 Elm St NE
Albuquerque, NM 87102-2512

Phone

(575) 308-3787

Fax

(505) 843-8886

NPI assigned

Nov 2, 2023

Last updated

Nov 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1265205108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 PITT ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124240",
            "telephone_number": "575-308-3787",
            "fax_number": "505-843-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "575-308-3787",
            "fax_number": "505-843-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "JASON",
        "middle_name": "COREY",
        "name_prefix": "Mr.",
        "credential": "MSN, RN, CCRN, FANAI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NM",
            "license": "RN-80349",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NM",
            "license": "RN-80349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bloom Wellness Center, LLC
• Leesa Robin Bloom
• Ricki Bloom, LMSW-P
• Bloome Healing LLC
• Jessica L Bloome, MA, LPCC
• Blooming Cactus Wellness LLC
• Blooming Tree ABA, LLC
• Blossom ABA Therapy NM LLC
• Cheryl Lynne Blossom, MSW
• Karen Blossom, PA-C

• Critical Care Medicine Registered Nurse in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Critical Care Medicine Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.