Bobbyjo Bloom, RN, IBCLC, CCE

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

087534 Issued in CT

Practice address

209 Range Rd
Wilton, CT 06897-3923

Phone

(301) 807-3508

NPI assigned

May 14, 2007

Last updated

Jan 14, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1518173087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 RANGE RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973923",
            "telephone_number": "203-210-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 RANGE RD",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068973923",
            "telephone_number": "301-807-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BOBBYJO",
        "name_prefix": "Mrs.",
        "credential": "RN, IBCLC, CCE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "R143852",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CT",
            "license": "087534",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MD",
            "license": "101-17052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Campbell Bender, LMSW
• Sally R. Bergwerk, MD
• Brandon Bico, PT
• Kristina Bikoulova, APRN
• Andrea Blake, OTR
• Lauren Blose
• Blue ABA Connecticut LLC
• Richard S Boas
• Lauren Boggs, PHYSICIAN ASSISTANT
• Alexandra Marie Bolan, LCSW

• Lactation Consultant (Registered Nurse) in Wilton, CT
• Providers in Wilton, CT by specialty
• Lactation Consultant (Registered Nurse) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.