Iaisa Shikema Bloom, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11010245 Issued in FL

Practice address

10301 Hagen Ranch Rd Ste B6
Boynton Beach, FL 33437-3723

Phone

(561) 752-9490

Fax

(561) 752-9491

NPI assigned

Dec 30, 2020

Last updated

Jul 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL, AZ2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Fams4099

  • Specialist
  • Naples, FL
  • NPI 1689436404
  Medicare reassignment NPD
• Life Blooms Healthcare Services, LLC

  dba Life Blooms IV Hydration Health & Wellness Mobile Bar

  • Infusion Therapy Clinic/Center
  • Miami Gardens, FL
  • NPI 1316699283
  NPD Authorized official
• Life Blooms Home, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Miami Gardens, FL
  • NPI 1851231567
  NPD Authorized official

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1326635970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 NW 212TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330561019",
            "telephone_number": "305-785-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 HAGEN RANCH RD STE B6",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334373723",
            "telephone_number": "561-752-9490",
            "fax_number": "561-752-9491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 NW 212th St",
            "address_purpose": "LOCATION",
            "city": "Miami Gardens",
            "state": "FL",
            "postal_code": "330561019",
            "country_code": "US",
            "telephone_number": "305-785-7259",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1065 NE 125th St Ste 206",
            "address_purpose": "LOCATION",
            "city": "North Miami",
            "state": "FL",
            "postal_code": "331615832",
            "country_code": "US",
            "telephone_number": "305-891-0050",
            "fax_number": "305-891-4228",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7481 W Oakland Park Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "333194985",
            "country_code": "US",
            "telephone_number": "954-771-7743",
            "fax_number": "954-771-7748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "IAISA",
        "middle_name": "SHIKEMA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010245",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARPN11010245",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Steven Blank, M.D.
• Dana Blasko, P.A.
• Dana Hailey Blocker, APRN
• Erin Blood, RPH
• Bloom Nutritional Services LLC
• Bloomingnest Services LLC
• Blue Butterfly Concierge LLC
• Blue Hearts Dental II
• Blue Mercury Med Care LLC
• Shelley Dana Blue, DC

• Family Nurse Practitioner in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.