Kerry Mark Bloom, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

10986 Issued in TX

Practice address

6560 Fannin St Ste 1434
Houston, TX 77030-2713

Phone

(713) 795-0130

Fax

(713) 795-0470

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kbloom28033@directhoustonmethodist.org

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386652402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1434",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302713",
            "telephone_number": "713-795-0130",
            "fax_number": "713-795-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 1434",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302713",
            "telephone_number": "713-795-0130",
            "fax_number": "713-795-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "KERRY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "10986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexi Bloom
• Carl Bloom, D.M.D.
• Douglas Randal Bloom, PHD
• Elizabeth S Bloom, M.D.
• Judi E Bloom, LPC
• Manuel G Bloom Jr., M.D
• Martin L Bloom, M.D.
• Mona B Bloom, M.D.
• Olivia Bloom
• Bloomcare & Co LLC

• Dentist in Houston, TX
• Providers in Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.