NPIMap

Individual provider Active NPI

Jayme Beth Bloom, DPT

  • Physical Therapist
  • Pikesville, MD
National Provider Identifier
1407141617
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23665 Issued in MD
Practice address
1836 Greene Tree Rd
Suite 2
Pikesville, MD 21208-1381
Phone
(410) 486-9992
NPI assigned
Jun 15, 2011
Last updated
Jan 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 23665 MD Primary

Addresses

Primary practice location

1836 Greene Tree Rd
Suite 2
Pikesville, MD 21208-1381

Mailing address

1836 Greene Tree Rd
Suite 2
Pikesville, MD 21208-1381

Other names 1

  • Jayme Beth Shirk Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23665MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University Ambulance Service Past Accepting new patients
Phoenix Rehabilitation and Health Services, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1407141617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 GREENE TREE RD",
            "address_2": "SUITE 2",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 GREENE TREE RD",
            "address_2": "SUITE 2",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081381",
            "telephone_number": "410-486-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JAYME",
        "middle_name": "BETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYME",
            "last_name": "SHIRK",
            "middle_name": "BETH",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.