Jessica Bloom Buckley

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

73554 Issued in WV

Practice address

3200 Maccorkle Ave SE
Charleston, WV 25304

Phone

(304) 388-4077

Fax

(304) 388-9852

NPI assigned

Oct 24, 2006

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

Other names 1

• Jessica Anne Bloom Former name

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charleston Area Medical Center IncGroup PAC ID 3375441637, 969 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.94 of 100Reported as apm

Quality

69.71

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17503/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/charles-8f0482a8

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.

• Charleston Area Medical Center, Inc.

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1124248752

  WV

  Medicare reassignment Care Compare group NPD
• Montgomery General Hospital, Inc

  • Critical Access Hospital
  • Montgomery, WV
  • NPI 1619913647

  WV

  Medicare reassignment NPD
• Professional Anesthesia Service,Inc.

  • Anesthesiology Physician
  • Charleston, WV
  • NPI 1720035827

  WV

  Medicare reassignment NPD
• Safe & Sound Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Beckley, WV
  • NPI 1215654553

  Nurse Anesthetist, Certified Registered, WV

  Medicare reassignment NPD
• Charleston Surgical Hospital, LLC

  • General Acute Care Hospital
  • Charleston, WV
  • NPI 1104904143
  NPD
• Montgomery General Hospital, Inc

  • Rural Health Clinic/Center
  • Montgomery, WV
  • NPI 1275163644
  NPD
• Charleston Area Medical Center Inc

  • Multi-Specialty Clinic/Center
  • Belpre, OH
  • NPI 1588422547
  NPD
• Charleston Surgical Hospital Healthcare Group, PLLC

  • Surgery Physician
  • Charleston, WV
  • NPI 1285131144
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396828992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DAWN PLACE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25314",
            "telephone_number": "304-344-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-4077",
            "fax_number": "304-388-9852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKLEY",
        "first_name": "JESSICA",
        "middle_name": "BLOOM",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "61450",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "73554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R MEDICARE",
            "identifier": "P00274757",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004241",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BLOOM",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walter Buchanan Jr.
• Pauline Buckhannaon
• Orual Buckingham
• Halie Buckland
• Jacob Buckler
• Angela Buckner
• Bradford Clinton Buddenberg, CRNA
• Julie M Budinger, MSN RNCS CRNP
• Jennifer Bugg
• Jennifer Bulger, D.C.

• Certified Registered Nurse Anesthetist in Charleston, WV
• Providers in Charleston, WV by specialty
• Certified Registered Nurse Anesthetist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.