Bloomfield College

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

BLOOMFIELD COLLEGE

Doing business as

Bloomfield Sports Medicine

Practice address

467 Franklin St
Bloomfield, NJ 07003-3425

Phone

(972) 367-4845

NPI assigned

Jan 31, 2018

Organization subpart

No

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

Authorized official

Name

Mouzon Bass III

Title

Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Bloomfield Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1649778044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SPRING VALLEY RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 FRANKLIN ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033425",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloomfield Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jenna L. Bidoglio, ATC
• Maria Grace Billings, PHD, LPC
• Danielle C Bloom
• Bloomfield Board of Education
• Bloomfield Care Pharmacy Corp
• Bloomfield Dental Arts, P.C.
• Bloomfield Dental Designs
• Bloomfield Drugs LLC
• Bloomfield Emergency Medical Services Inc
• Bloomfield Foot & Ankle , LLC

• Orthopaedic Surgery Physician in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.