Carol B. Bloom, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1231-024 Issued in WI

Practice address

2214 Main Street
La Crosse, WI 54601-3918

Phone

(608) 784-6970

Fax

(608) 784-6970

NPI assigned

Feb 15, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Carol Ann Bloom Other name

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": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1366610099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013918",
            "telephone_number": "608-784-6970",
            "fax_number": "608-784-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 MAIN STREET",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546013918",
            "telephone_number": "608-784-6970",
            "fax_number": "608-784-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "CAROL",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1231-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40062700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "BLOOM",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephen John Bloechl, M.D.
• Gabrielle Margarete Bloemke
• Jada A Blokhuis, PA-C
• Karen J. Blonsky, LCSW
• Bloodmoon Industry
• Lisa Ann Bloom
• Kimberly J Bloss, COTA
• Lydia Blum
• Kathryn Bluske, PA-C
• Tyler S Bluske, SAC-IT

• Physical Therapist in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.