Organization Active NPI

Luna Bloom Psychiatry LLC

  • Adult Mental Health Clinic/Center
  • Columbus, OH
National Provider Identifier
1578427381
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
LUNA BLOOM PSYCHIATRY LLC
Practice address
2025 Riverside Dr Ste 618
Columbus, OH 43221-4012
Phone
(614) 324-9099
NPI assigned
Dec 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Mrs. Ashley NerusuNPI 1376341941
Title
Ceo
Phone
(614) 324-9099

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

2025 Riverside Dr Ste 618
Columbus, OH 43221-4012

Mailing address

2025 Riverside Dr Ste 618
Columbus, OH 43221-4012
Phone (614) 324-9099

Other practice location 1

1110 Brickell Ave Ste 400
Miami, FL 33131-3135
Phone (614) 324-9099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260415002299 OH Part B Supplier - Clinic/Group Practice 7810463171 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, OH

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": "1765756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1578427381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 RIVERSIDE DR STE 618",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432214012",
            "telephone_number": "614-324-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 RIVERSIDE DR STE 618",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432214012",
            "telephone_number": "614-324-9099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1110 Brickell Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331313135",
            "country_code": "US",
            "telephone_number": "614-324-9099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUNA BLOOM PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-15",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "NERUSU",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "614-324-9099",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.