Kendall Blake Bloomer, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

14973 Issued in FL

Practice address

401 SE Osceola St
Stuart, FL 34994-2503

Phone

(772) 247-1077

NPI assigned

Apr 2, 2024

Sex

Male

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

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Wellness Centers LLCGroup PAC ID 8527122241, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Premier Wellness Centers LLC

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1639322712
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1437901774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 SE OSCEOLA ST",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942503",
            "telephone_number": "772-247-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "KENDALL",
        "middle_name": "BLAKE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "14973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan M Blasinsky, CRNA
• Kaitlynn Blasquez, BEHAVIORAL ANALYST
• Shaun Michael Blaylock
• Christy C Blazer
• Robert Bloom
• Christine D. Blount, LCSW
• Elizabeth P Blowers, MD
• Blue Seas Medical LLC
• Kiara Blue
• Bluesky Telepsych LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.