Gerald Blossom, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD12728 Issued in TN

Practice address

2018 W Clinch Ave
Knoxville, TN 37916-2301

Phone

(865) 541-8000

NPI assigned

Jun 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568499820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12005 BUTTERNUT LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379344672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 W CLINCH AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162301",
            "telephone_number": "865-541-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOSSOM",
        "first_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD12728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3018602",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50368",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64748205",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas Vance Bloom
• Jason Eric Bloom, DC
• Blooming Tree Homes LLC
• Blooming Tree Homes LLC
• Kelly Blosser, BCABA
• Blount Orthopaedic Associates PA
• Blue Dog Family Dentistry
• Blue Horizon Marriage and Family Therapy Inc
• Amelie Fernandez Ruazol Blue, LMSW
• Charles Thurber Blue, MD

• Emergency Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.