NPIMap

Organization Active NPI

Bloom Therapy and Wellness, LLC

  • Pediatric Occupational Therapist
  • Janesville, WI
National Provider Identifier
1477339679
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
BLOOM THERAPY AND WELLNESS, LLC
Practice address
3412 Cricketeer Dr
Janesville, WI 53546-9657
Phone
(608) 218-4602
NPI assigned
Sep 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Authorized official

Name
Bethany Weberpal, OTR/LNPI 1083248447
Title
Occupational Therapist, Owner
Phone
(608) 218-4602

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

3412 Cricketeer Dr
Janesville, WI 53546-9657

Mailing address

3412 Cricketeer Dr
Janesville, WI 53546-9657
Phone (608) 218-4602

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693785600000",
    "number": "1477339679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 CRICKETEER DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535469657",
            "telephone_number": "608-218-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 CRICKETEER DR",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535469657",
            "telephone_number": "608-218-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A",
        "authorized_official_last_name": "WEBERPAL",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "608-218-4602",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.