Jacy Bloom, D.C. M.S.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 11985 Issued in FL

Practice address

2190 Tamiami TRL S
Venice, FL 34293-5040

Phone

(941) 493-2688

NPI assigned

Oct 12, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1407306517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BRENTWOOD LN",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234652",
            "telephone_number": "386-453-1839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 TAMIAMI TRL S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342935040",
            "telephone_number": "941-493-2688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JACY",
        "name_prefix": "Dr.",
        "credential": "D.C. M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11985",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa L Black, OD
• Darren J Blakeslee, ARNP
• Bliss Dermatology, LLC
• Jeffrey R. Blood, MD
• Hannah Rylee Bloom, PA-C
• Blue Horizon Anesthesia
• Blue Horizon Anesthesia
• Blue Sky Eyewear LLC
• Blue Sky Mining Company LLC
• Frank Blum

• Chiropractor in Venice, FL
• Providers in Venice, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.