Melissa Diane Bloom, MS, RD, LD, CEDRD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DT85824 Issued in TX

Practice address

6136 Frisco Square Blvd Ste 400
Frisco, TX 75034-3251

Phone

(469) 991-9865

NPI assigned

Aug 7, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Empowrd Nutrition

  • Registered Dietitian
  • Frisco, TX
  • NPI 1548835317

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1386020774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5830 GRANITE PKWY STE 100-344",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750246771",
            "telephone_number": "469-991-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 FRISCO SQUARE BLVD STE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750343251",
            "telephone_number": "469-991-9865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5830 Granite Pkwy Ste 100-344",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750246771",
            "country_code": "US",
            "telephone_number": "469-991-9865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "MELISSA",
        "middle_name": "DIANE",
        "credential": "MS, RD, LD, CEDRD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-07",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "1007678",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT85824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411003301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1C4310",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Frisco, TX
• Providers in Frisco, TX by specialty
• Registered Dietitian in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.