Bonnie Bloom, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6812 Issued in TX

Practice address

1422 N Loop 336 W
Suite B
Conroe, TX 77304-3540

Phone

(936) 539-2020

Fax

(936) 756-7916

NPI assigned

Aug 3, 2006

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 TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Conroe Vision Associates PA

  • Optometrist
  • Conroe, TX
  • NPI 1538527692
  Medicare reassignment NPD
• Northern Virginia Doctors of Optometry

  • Optometrist
  • Falls Church, VA
  • NPI 1801976055
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436918400000",
    "number": "1275541815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 N LOOP 336 W",
            "address_2": "SUITE B",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043540",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 N LOOP 336 W",
            "address_2": "SUITE B",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043540",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BONNIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2015-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harrison Gilbert Blefeld
• Cole Michael Blemings, DO
• Sharlese Bliss Bilbo
• Bliss Women's Wellness & Birth Center
• Bliss Women's Wellness & Birth Center
• Bloops Design LLC
• Grisel Bodden
• Brittany Emily Bodkin
• William J Boeck, RPH
• David M Boeckman, OD

• Optometrist in Conroe, TX
• Providers in Conroe, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.