Jake Bloms, DOCTOR OF PHARMACY

Primary specialty

PharmacistTaxonomy code 183500000X

License

125717 Issued in MN

Practice address

1921 Coborn Blvd
Saint Cloud, MN 56301-2100

Phone

(320) 252-4222

NPI assigned

Aug 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1326776006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 QUADAY AVE NE UNIT 303",
            "city": "OTSEGO",
            "state": "MN",
            "postal_code": "553306588",
            "telephone_number": "701-263-5774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 COBORN BLVD",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563012100",
            "telephone_number": "320-252-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMS",
        "first_name": "JAKE",
        "credential": "DOCTOR OF PHARMACY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "125717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE",
            "identifier": "125717",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Elizabeth Block, LPN
• Kristina Block
• Brianna Bloedorn, LICSW
• Melissa Ann Blom
• Krista Ann Blomdahl, D.C.
• Patricia Jane Blonigen-Heinen, LICSW
• Bethany Anne Blonigen, DDS
• Julia Anna Blonigen, M.S., CCC-SLP
• Stephanie Blonigen, OT
• Joseph M Blonski, MD

• Pharmacist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.