NPIMap

Organization Active NPI

Bloom Idaho LLC

Doing business as AFC Urgent Care

  • Multi-Specialty Clinic/Center
  • Garden City, ID
National Provider Identifier
1679134126
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BLOOM IDAHO LLC
Doing business as
AFC Urgent Care
Practice address
6965 N Glenwood St
Garden City, ID 83714-1967
Phone
(208) 853-3000
NPI assigned
Jun 25, 2019
Last updated
May 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Spencer Smith
Title
Ceo
Phone
(208) 853-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

6965 N Glenwood St
Garden City, ID 83714-1967

Mailing address

50 Henry St
Cortez, CO 81321-3012

Other names 1

  • AFC Urgent Care Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

50 Henry St
Cortez, CO 81321

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1679134126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 HENRY ST",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "813213012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 N GLENWOOD ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141967",
            "telephone_number": "208-853-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM IDAHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-853-3000"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AFC Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AFC Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden City, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.