Individual provider Active NPI

Lindsey Bloom, ACCNS-AG

  • Critical Care Medicine Clinical Nurse Specialist
  • Roseville, CA
National Provider Identifier
1629964168
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
License
5178 Issued in CA
Practice address
1 Adventist Health Way
Roseville, CA 95661-3266
Phone
(818) 395-6956
NPI assigned
Jun 12, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Clinical Nurse Specialist 364SC0200X 5178 CA Primary

Addresses

Primary practice location

1 Adventist Health Way
Roseville, CA 95661-3266

Mailing address

18701 Tulsa St
Porter Ranch, CA 91326-2717
Phone (818) 395-6956

Other practice location 1

18701 Tulsa St
Porter Ranch, CA 91326-2717
Phone (818) 395-6956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5178CAMDCritical Care Medicine Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1629964168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18701 TULSA ST",
            "city": "PORTER RANCH",
            "state": "CA",
            "postal_code": "913262717",
            "telephone_number": "818-395-6956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ADVENTIST HEALTH WAY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613266",
            "telephone_number": "818-395-6956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18701 Tulsa St",
            "address_purpose": "LOCATION",
            "city": "Porter Ranch",
            "state": "CA",
            "postal_code": "913262717",
            "country_code": "US",
            "telephone_number": "818-395-6956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "LINDSEY",
        "credential": "ACCNS-AG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "CA",
            "license": "5178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.