NPIMap

Organization Active NPI

Bloom Hospice of Texas, LLC

Doing business as Bloom Hospice

  • Community Based Hospice Care Agency
  • San Antonio, TX
National Provider Identifier
1649002908
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
BLOOM HOSPICE OF TEXAS, LLC
Doing business as
Bloom Hospice
Practice address
8000 W Interstate 70
Ste. 201
San Antonio, TX 78230-3668
Phone
(210) 500-3030
Fax
(210) 352-9133
NPI assigned
Aug 15, 2024
Last updated
Aug 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BLOOM HOSPICE OF TEXAS HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Authorized official

Name
John Freeman
Title
President
Phone
(210) 500-3030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

8000 W Interstate 70
Ste. 201
San Antonio, TX 78230-3668

Mailing address

8000 W Interstate 70
Ste. 201
San Antonio, TX 78230-3668
Phone (210) 903-0000

Other names 1

  • Bloom Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250220000835 TX Part A Provider - Hospice 2466972518 Practice locations: San Antonio, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649002908. Details of each certification follow.

Hospice certification: CCN A91752

Legal name
BLOOM HOSPICE OF TEXAS, LLC
Doing business as
BLOOM HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 17, 2025
Last certification
Apr 17, 2025
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
8000 I-10W
#201
San Antonio, TX 78230-3868

Care Compare: Hospice

Medicare Care Compare
Listed as
Bloom HospiceCCN A91752 · All quality measures
Certified
Apr 17, 2025
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

8000 W Interstate 10
Ste 201
San Antonio, TX 78230
Phone (210) 433-9922

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas J Lally Individual 5% Or Greater Indirect Ownership InterestOwner Aug 2, 2024 19.6%
OtherGoverning Body Member Aug 2, 2024 25%
John L Freeman Individual 5% Or Greater Indirect Ownership InterestOwner Aug 2, 2024 19.6%
W-2 Managing Employee Aug 2, 2024 100%
Other Aug 2, 2024 25%
Bloom Hospice Texas Holdings, LLC Organization, Lakewood, CO LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 2, 2024 100%
Franke P Elliott Individual 5% Or Greater Indirect Ownership InterestOwner Aug 2, 2024 9.8%
Michael Bunting Individual 5% Or Greater Indirect Ownership InterestOwner Aug 2, 2024 7%
OtherGoverning Body Member Aug 2, 2024 25%
Bloom Healthcare Organization, Lakewood, CO Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 2, 2024 100%
Jeanine Lally Individual 5% Or Greater Indirect Ownership InterestOwner Aug 2, 2024 19.6%
OtherGoverning Body Member Aug 2, 2024 25%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1649002908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 W INTERSTATE 70",
            "address_2": "STE. 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303668",
            "telephone_number": "210-903-0000",
            "fax_number": "210-944-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 W INTERSTATE 70",
            "address_2": "STE. 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303668",
            "telephone_number": "210-500-3030",
            "fax_number": "210-352-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM HOSPICE OF TEXAS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLOOM HOSPICE OF TEXAS HOLDINGS, LLC",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "FREEMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-500-3030"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloom Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bloom Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.