Individual provider Active NPI

Joanna L Bloomer, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenup, KY
National Provider Identifier
1407197635
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3007891 Issued in KY
Practice address
57 Dora LN
Greenup, KY 41144-1187
Phone
(866) 233-1955
NPI assigned
Mar 13, 2013
Last updated
Feb 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3007981 KY
Adult Health Nurse Practitioner 363LA2200X 3007981 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3007891 KY Primary

Addresses

Primary practice location

57 Dora LN
Greenup, KY 41144-1187

Mailing address

3701 Landsdowne Dr
Ashland, KY 41102-5422
Phone (606) 324-3005

Other practice location 1

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 212-4468

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20140327000471 KY Practitioner - Nurse Practitioner 6800027236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways IncGroup PAC ID 1254239171, 60 clinicians

Practice addresses (Care Compare)

3701 Landsdowne Dr
Ashland, KY 41102-5422
Phone (606) 329-8588

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3007891KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways, Inc Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients
Pathways Inc Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients

Locations

3701 Landsdowne Dr
Ashland, KY 41102
Phone (606) 324-3005

840 Interstate Dr
Grayson, KY 41143
Phone (606) 474-5151

57 Dora Ln
Greenup, KY 41144
Phone (606) 473-7333

Interoperability endpoints

  • Direct secure messaging: jbloomer241483@direct-prd.stelizabeth.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1407197635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 LANDSDOWNE DR",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411025422",
            "telephone_number": "606-324-3005",
            "fax_number": "606-329-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 DORA LN",
            "city": "GREENUP",
            "state": "KY",
            "postal_code": "411441187",
            "telephone_number": "866-233-1955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "859-212-4468",
            "fax_number": "859-212-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "JOANNA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-13",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3007981",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3007981",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3007891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenup, KY

Sources for this page

Verify at the official NPI Registry.