Active NPI
Amy Lynn Bloom, M.S.
- Psychologist
- Oakwood, OH
National Provider Identifier
1386042455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1098118
- Practice address
- 433 Thornhill Rd
Oakwood, OH 45419-2932 - Phone
- (937) 371-3615
- NPI assigned
- Dec 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1098118 | OH | Primary |
Addresses
Primary practice location
433 Thornhill Rd
Oakwood, OH 45419-2932
Mailing address
433 Thornhill Rd
Oakwood, OH 45419-2932
Phone (937) 371-3615
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1098118 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417737600000",
"number": "1386042455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "433 THORNHILL RD",
"city": "OAKWOOD",
"state": "OH",
"postal_code": "454192932",
"telephone_number": "937-371-3615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "433 THORNHILL RD",
"city": "OAKWOOD",
"state": "OH",
"postal_code": "454192932",
"telephone_number": "937-371-3615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOOM",
"first_name": "AMY",
"middle_name": "LYNN",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2014-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "1098118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakwood, OH
- Allison Nicole Allread, NURSE PRACTITIONER
- Julie Angel, APRN
- Bonnie J Ashley, LABOC, NCLEC
- Gina Theresa Atchison, P.A.
- Susan Elaine Berner, M.D.
- Bonavista Optics Incorporated
- Ilyas Bourchid
- Michelle Sovern Boyer, PA-C
- Brandeana Santera Marie Breden
- Brookdale Place at Oakwood, LLC (Brookdale Oakwood)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.