NPIMap

Organization Active NPI

Bloomkidz Inc.

  • Behavior Analyst
  • Chandler, AZ
National Provider Identifier
1457009789
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLOOMKIDZ INC.
Practice address
2141 E Pecos Rd
Chandler, AZ 85225-6077
Phone
(480) 846-0607
Fax
(480) 841-6696
NPI assigned
Mar 15, 2022
Last updated
Mar 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Daniel Scott Feavel
Title
Ceo
Phone
(928) 853-6052

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X
Pediatric Physical Therapist 2251P0200X
Pediatric Occupational Therapist 225XP0200X
Speech-Language Pathologist 235Z00000X
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2141 E Pecos Rd
Chandler, AZ 85225-6077

Mailing address

2141 E Pecos Rd
Chandler, AZ 85225-6077
Phone (480) 846-0607

Other practice location 1

2121 E Pecos Rd
Chandler, AZ 85225-6075
Phone (480) 846-0607

Other identifiers 3

IdentifierTypeStateIssuer
155000MedicaidAZ
BH9666OtherAZARIZONA DEPARTMENT OF HEALTH SERVICES
OTC13281OtherAZARIZONA DEPARTMENTS OF HEALTH SERVICES

National Provider Directory

National Provider Directory
Tax ID family
Bloomkidz2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2121 E Pecos Rd
Chandler, AZ 85225
Phone (480) 846-0607

2121 E Pecos Rd
Ste 12
Chandler, AZ 85225

2141 E Pecos Rd
Chandler, AZ 85225
Phone (480) 846-0607

2141 E Pecos Rd
Ste 1
Chandler, AZ 85225
Phone (480) 846-0607

1208 King St
Ste 500
Chattanooga, TN 37403

Practitioners & affiliated clinicians

Practitioners 86

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 86

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1457009789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 E PECOS RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256077",
            "telephone_number": "480-846-0607",
            "fax_number": "480-841-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 E PECOS RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256077",
            "telephone_number": "480-846-0607",
            "fax_number": "480-841-6696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 E Pecos Rd",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852256075",
            "country_code": "US",
            "telephone_number": "480-846-0607",
            "fax_number": "480-841-6696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOOMKIDZ INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "FEAVEL",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-853-6052"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155000",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENT OF HEALTH SERVICES",
            "identifier": "BH9666",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENTS OF HEALTH SERVICES",
            "identifier": "OTC13281",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.