Active NPI
William S. Bloom, MD
- Ophthalmology Physician
- Hanover, NH
National Provider Identifier
1285664821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 042-0011254
- Practice address
- 80 S Main St
Hanover, NH 03755-2053 - Phone
- (603) 643-3232
- Fax
- (603) 643-1877
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 042-0011254 | VT | Primary |
Addresses
Primary practice location
80 S Main St
Hanover, NH 03755-2053
Mailing address
80 S Main St
Hanover, NH 03755-2053
Phone (603) 643-3232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009344 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0011254 | VT | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185926400000",
"number": "1285664821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 S MAIN ST",
"city": "HANOVER",
"state": "NH",
"postal_code": "037552053",
"telephone_number": "603-643-3232",
"fax_number": "603-643-1877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 S MAIN ST",
"city": "HANOVER",
"state": "NH",
"postal_code": "037552053",
"telephone_number": "603-643-3232",
"fax_number": "603-643-1877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "WILLIAM",
"middle_name": "S.",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2007-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VT",
"license": "042-0011254",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009344",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hanover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.