Individual provider Active NPI

Jessica Katherine Bloom, PHARM D

  • Pharmacist
  • Smyrna, DE
National Provider Identifier
1639336381
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
A10003720 Issued in DE
Practice address
200 Pharmacy Drive
Smyrna, DE 19977
Phone
(302) 659-1267
NPI assigned
May 20, 2008
Last updated
May 20, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X A10003720 DE Primary

Addresses

Primary practice location

200 Pharmacy Drive
Smyrna, DE 19977

Mailing address

200 Pharmacy Drive
Smyrna, DE 19977
Phone (302) 659-1267

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
A10003720DEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Delaware Inc Past Accepting new patients
Rite Aid of Delaware Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1639336381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PHARMACY DRIVE",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "19977",
            "telephone_number": "302-659-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PHARMACY DRIVE",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "19977",
            "telephone_number": "302-659-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "JESSICA",
        "middle_name": "KATHERINE",
        "name_prefix": "Miss",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "DE",
            "license": "A10003720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.