Anita Amanda Bloomingburg, CNA

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Practice address

829 E 153Rd St
Phoenix, IL 60426-2554

Phone

(815) 764-6631

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407417199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 W 18TH ST APT 17",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608041962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 E 153RD ST",
            "city": "PHOENIX",
            "state": "IL",
            "postal_code": "604262554",
            "telephone_number": "815-764-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMINGBURG",
        "first_name": "ANITA",
        "middle_name": "AMANDA",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medi-Ship Transportation Inc

• Nurse's Aide in Phoenix, IL
• Providers in Phoenix, IL by specialty
• Nurse's Aide in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.