Charles R Bloomer, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12413 Issued in TX

Practice address

5200 Buffalo Gap Rd Ste B
Abilene, TX 79606-4151

Phone

(325) 691-1140

Fax

(325) 691-1141

NPI assigned

Jan 22, 2007

Last updated

Jan 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral Surgery

Education

The Dental School at University of Texas HSC at San Antonio, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1336293091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 BUFFALO GAP RD STE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796064151",
            "telephone_number": "325-691-1140",
            "fax_number": "325-691-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 BUFFALO GAP RD STE B",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796064151",
            "telephone_number": "325-691-1140",
            "fax_number": "325-691-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "12413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Blare
• Hillary Blare
• John Houston Bliznak, M.D.
• Johnny Bliznak, M.D.
• Amanda Bloch
• Kofi Boamah-Acheampong, PHARM.D
• Donna Lou Boatwright, PHARMD
• Body Worx Physical Therapy
• Bodywork Revive Life Spa (ReVive Integrative Wellness)
• Linda Rae Boeshart, MS CCC/SLP

• Oral and Maxillofacial Surgery (Dentist) in Abilene, TX
• Providers in Abilene, TX by specialty
• Oral and Maxillofacial Surgery (Dentist) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.