NPIMap

Organization Active NPI

Bloom

  • Home Health Aide
  • Mesa, AZ
National Provider Identifier
1386517035
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Legal business name
BLOOM
Practice address
114 W Main St Ste 35
Mesa, AZ 85201-7310
Phone
(623) 296-2943
NPI assigned
Sep 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Charae JacksonNPI 1861235756
Title
Director
Phone
(623) 296-2943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Meals Provider 174200000X
Home Health Agency 251E00000X
Community Based Hospice Care Agency 251G00000X
In Home Supportive Care Agency 253Z00000X
Home Delivered Meals 332U00000X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X Primary

Addresses

Primary practice location

114 W Main St Ste 35
Mesa, AZ 85201-7310

Mailing address

114 W Main St Ste 35
Mesa, AZ 85201-7310
Phone (623) 296-2943

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1759104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1386517035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W MAIN ST STE 35",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017310",
            "telephone_number": "623-296-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W MAIN ST STE 35",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017310",
            "telephone_number": "623-296-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-06",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHARAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "623-296-2943"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.