Bloom Med, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

BLOOM MED, LLC

Practice address

2301 S Stearman Dr
Chandler, AZ 85286-2263

Phone

(520) 800-5676

NPI assigned

Jul 8, 2025

Organization subpart

No

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

Authorized official

Name

Mark Goforth, MHPFNP

Title

Owner

Phone

(520) 904-7987

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1447140504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S STEARMAN DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862263",
            "telephone_number": "520-800-5676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S STEARMAN DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852862263",
            "telephone_number": "520-800-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM MED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "GOFORTH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-904-7987",
        "authorized_official_credential": "MHPFNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysse Sky Blight, PA-C
• Kayla Block, MC, LAC
• Jill Bloedel, RPH
• Brodi Rae Blomdahl, B.S
• Bloom and Prosper Therapy
• Bloom Pediatric Dentistry, PLLC
• Daniel Bloom
• Blooming Clematis Therapy & Consulting LLC
• Bloomkidz Inc.
• Bloomkidz Inc.

• Health Service Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Health Service Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; 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.