Bloom Colorado LLC
Organization Active NPI Urgent Care Clinic/Center · Cortez, CO
NPI 1306501341 · NPPES record last updated Nov 4, 2021
Key facts
- NPI
- 1306501341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- BLOOM COLORADO LLC
- Practice address
- 1942 E Main St
Cortez, CO 81321-3039 - Phone
- (970) 609-2001
- NPI assigned
- Nov 4, 2021
- Organization subpart
- Yes
- Parent organization (as reported)
- BLOOM CARE LLC
Authorized official
- Name
- Spencer Smith
- Title
- Ceo
- Phone
- (970) 609-2001
Other NPIs on the same Medicare enrollment 2
Member of 1
Practitioners 2
-
Cathy M McCoy, FNP-BC, PMHNP-BC
-
Nicole Pistono, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220523002698 | CO | Part B Supplier - Clinic/Group Practice | 2860879368 |
Receives reassigned benefits from 24 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Grand Junction, CO; Colorado Springs, CO |
National Provider Directory
- Part of
- Bloom Care LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
1942 E Main St
Cortez, CO 81321-3039
Mailing address
PO Box 5943
Virginia Beach, VA 23471-0943
Other names
- AFC Urgent Care
Other providers in Cortez, CO
- Debra Berger
- Robert Michael Berger
- Margaret A Blackmer
- Amanda Joan Blacow
- Blair W Pyle MD PC
- Daniel James Bohle
- Natasha Bouchillon
- Linda Bouet
- Israel Bowers
- Jacob Twyman Boyer
All providers in Cortez, CO · Urgent Care Clinic/Center in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.