Organization Active NPI

Northern Bloom Health and Wellness, LLC

  • Family Medicine Physician
  • Palmer, AK
National Provider Identifier
1285501593
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
NORTHERN BLOOM HEALTH AND WELLNESS, LLC
Practice address
1901 N Hemmer Rd Apt 208
Palmer, AK 99645-9673
Phone
(907) 203-4677
Fax
(800) 516-0397
NPI assigned
Oct 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Samantha Gibson, ANP-BC, APRN
Title
Owner
Phone
(907) 982-3285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1901 N Hemmer Rd Apt 208
Palmer, AK 99645-9673

Mailing address

1901 N Hemmer Rd Apt 208
Palmer, AK 99645-9673
Phone (907) 203-4677

National Provider Directory

National Provider Directory

Locations

1901 N Hemmer Rd
Apt 208
Palmer, AK 99645
Phone (907) 203-4677

NPI Registry JSON

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1285501593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N HEMMER RD APT 208",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996459673",
            "telephone_number": "907-203-4677",
            "fax_number": "800-516-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N HEMMER RD APT 208",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996459673",
            "telephone_number": "907-203-4677",
            "fax_number": "800-516-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN BLOOM HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-982-3285",
        "authorized_official_credential": "ANP-BC, APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.