Bloomer Nursing and Rehab LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

BLOOMER NURSING AND REHAB LLC

Doing business as

Meadowbrook at Bloomer

Practice address

1840 Priddy St
Bloomer, WI 54724-1546

Phone

(715) 568-2503

NPI assigned

Sep 15, 2019

Last updated

Feb 3, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rostislav Pukshansky

Title

Partner

Phone

(847) 942-7575

Specialties & licenses 1

Addresses

Other names 1

• Meadowbrook at Bloomer Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346890076. Details of each certification follow.

• CCN 525580 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 525580

Legal name

BLOOMER NURSING AND REHAB LLC

Doing business as

MEADOWBROOK AT BLOOMER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1995

Last certification

Mar 13, 2025

Beds

31

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Synergy Senior Care LLC

Organization structure

LLCProprietary

Incorporated

Sep 9, 2019 in WI

Enrollment address

1840 Priddy St
Bloomer, WI 54724-1546

Nursing home name

MEADOWBROOK AT BLOOMER

Affiliated entity

SYNERGY SENIOR CARE

Listed as

Meadowbrook at BloomerCCN 525580 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Oct 1, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

3126.6 residents per day on average

Chain

Synergy Senior Care5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Erik Joel Dickson, MD

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1982714473

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• BRF Nursing and Rehab LLC

  dba Meadowbrook at Black River Falls

  • Skilled Nursing Facility
  • Black River Falls, WI
  • NPI 1164072898

  Synergy Senior Care LLC

  CMS ownership
• Chetek Nursing and Rehab LLC

  dba Meadowbrook at Chetek

  • Skilled Nursing Facility
  • Chetek, WI
  • NPI 1982254611

  Synergy Senior Care LLC

  CMS ownership
• Oconto Falls Nursing and Rehab LLC

  dba Meadowbrook at Oconto Falls

  • Skilled Nursing Facility
  • Oconto Falls, WI
  • NPI 1609426337

  Synergy Senior Care LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Erik Joel Dickson, MD

  • Family Medicine Physician
  • Chippewa Falls, WI
  • NPI 1982714473

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1346890076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD STE 119",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "847-942-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 PRIDDY ST",
            "city": "BLOOMER",
            "state": "WI",
            "postal_code": "547241546",
            "telephone_number": "715-568-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMER NURSING AND REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-15",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "PUKSHANSKY",
        "authorized_official_first_name": "ROSTISLAV",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "847-942-7575"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowbrook at Bloomer",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meadowbrook at Bloomer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan M Block, RD
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• Bloomer Chiropractic LLC
• Bloomer Chiropractic Office, Inc.
• Bloomer Healthcare, LLC (Dove Healthcare- Bloomer)
• Bloomer Rehabilitation and Nursing Center LLC (Dove Healthcare - Bloomer)
• Bloomer School District
• Blue Diamond Family Dental SC
• Cynthia Bonk
• Tyler Bosshart

• Skilled Nursing Facility in Bloomer, WI
• Providers in Bloomer, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.