Individual provider Active NPI

William Richard Bleam III, D.C.

  • Chiropractor
  • Eldersburg, MD
National Provider Identifier
1386759546
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S02189 Issued in MD
Practice address
5965 Exchange Dr Ste M
Eldersburg, MD 21784-9276
Phone
(410) 795-0400
Fax
(410) 687-8735
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S02189 MD Primary

Addresses

Primary practice location

5965 Exchange Dr Ste M
Eldersburg, MD 21784-9276

Mailing address

5965 Exchange Dr Ste M
Eldersburg, MD 21784-9276
Phone (410) 795-0400

Other practice location 1

1425 Liberty Rd
Suite 200
Eldersburg, MD 21784-6420
Phone (410) 795-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040628000308 MD Practitioner - Chiropractic 7911983291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freedom Chiropractic and RehabilitationGroup PAC ID 2668797440, 2 clinicians

Practice addresses (Care Compare)

1643 Liberty Rd
Suite 206
Eldersburg, MD 21784-6543
Phone (410) 795-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S02189MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Chiropractic and Rehabilitation CurrentSince Jan 1, 2015 Accepting new patients

Locations

1643 Liberty Rd
Ste 206
Eldersburg, MD 21784
Phone (410) 795-0400

5965 Exchange Dr
Ste M
Sykesville, MD 21784
Phone (410) 795-0400

1425 Liberty Rd
Ste 200
Sykesville, MD 21784
Phone (410) 795-0400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1386759546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5965 EXCHANGE DR STE M",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217849276",
            "telephone_number": "410-795-0400",
            "fax_number": "443-687-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5965 EXCHANGE DR STE M",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217849276",
            "telephone_number": "410-795-0400",
            "fax_number": "410-687-8735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Liberty Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Eldersburg",
            "state": "MD",
            "postal_code": "217846420",
            "country_code": "US",
            "telephone_number": "410-795-0400",
            "fax_number": "443-687-8735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEAM",
        "first_name": "WILLIAM",
        "middle_name": "RICHARD",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S02189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.