Bloom at Willow, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BLOOM AT WILLOW, LLC

Practice address

2725 Lake Circle Dr
Indianapolis, IN 46268-4931

Phone

(317) 334-9400

NPI assigned

Aug 18, 2023

Last updated

Aug 18, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Kantor

Title

President

Phone

(312) 282-4050

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1669255931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 E BROWN ST STE 315",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 LAKE CIRCLE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462684931",
            "telephone_number": "317-334-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM AT WILLOW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "KANTOR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-282-4050"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.