Susan Jone Bloom, PSY. D., APNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5697 Issued in WI

Practice address

6513 Sandpiper Dr
Coconut Creek, FL 33073-2414

Phone

(414) 455-0626

Fax

(414) 455-0626

NPI assigned

Apr 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Genesis Clinical Services

  • Multi-Specialty Clinic/Center
  • Wheaton, IL
  • NPI 1265432140
  NPD (past)
• Healthcare Psychology Consultants LLC

  • Clinical Psychologist
  • Shorewood, WI
  • NPI 1063532380
  NPD (past)
• Your Best Self Psychotherapy, LLP

  • Clinical Social Worker
  • Milwaukee, WI
  • NPI 1366941270
  NPD (past)

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1396989141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N JEFFERSON ST STE 408",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532023875",
            "telephone_number": "847-372-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6513 SANDPIPER DR",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732414",
            "telephone_number": "414-455-0626",
            "fax_number": "414-455-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "SUSAN",
        "middle_name": "JONE",
        "name_prefix": "Dr.",
        "credential": "PSY. D., APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5697",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11017246",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "5697",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sharon Blackman, RDN
• Felicia Blackwood
• Fedeline Blanc
• Patricia Blanco
• George Blanton, DO
• Bofshever Wellness Center LLC
• Harley J Bofshever, DC
• Teresa Marie Boland, ARNP, FAARM, LMFT
• Book Your Nurse Medical Services, LLC
• Kristi Bouras, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.