Samantha J Vander Bloomen, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

2658 Issued in WI

Practice address

700 West Ave S
La Crosse, WI 54601-8806

Phone

(608) 758-0940

NPI assigned

Sep 19, 2013

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1275969420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WEST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018806",
            "telephone_number": "608-758-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2520 Elisha Ave",
            "address_purpose": "LOCATION",
            "city": "Zion",
            "state": "IL",
            "postal_code": "60099",
            "country_code": "US",
            "telephone_number": "847-731-5075",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Division St",
            "address_purpose": "LOCATION",
            "city": "Mauston",
            "state": "WI",
            "postal_code": "539481931",
            "country_code": "US",
            "telephone_number": "608-847-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDER BLOOMEN",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "2658",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.006887",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeann E Van Vreede, MS
• Andrea J Van Wyk, M.D.
• Sylvia V Vanatta, M.D.
• Torey J Vande Walle, DDS
• Joseph P Vandenberg, MD
• Theodore William Vanderhorst, D.O.
• Laura K Vanderlei, PA
• Barbara J Vandreese, APNP
• Anthony Vang
• Shoua Vang, BACHELOR OF SCIENCE

• Registered Dietitian in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; 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.