Blossom Therapeutics, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

BLOSSOM THERAPEUTICS, LLC

Practice address

408 NE Hawthorne Ave
Bend, OR 97701-4729

Phone

(541) 617-8769

Fax

(541) 668-6772

NPI assigned

Nov 5, 2018

Last updated

Nov 5, 2018By 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

Ms. Jennifer Clark Johnson, OTR/LNPI 1265772974

Title

Therapist/Owner

Phone

(541) 604-0548

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Jennifer Clark Johnson, OTR/L

  • Pediatric Occupational Therapist
  • Bend, OR
  • NPI 1265772974

  Pediatrics

  NPD (past) Authorized official
• Cindy Renea Hatch-Rasmussen, M.A., OTR/L

  • Occupational Therapist
  • Bend, OR
  • NPI 1255679551
  NPD (past)
• Pamela Saul, M.ED.

  • Behavior Technician
  • Bend, OR
  • NPI 1053828772
  NPD (past)

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541376000000",
    "number": "1700354040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 NW FIELDS ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037317",
            "telephone_number": "541-604-0548",
            "fax_number": "541-668-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 NE HAWTHORNE AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014729",
            "telephone_number": "541-617-8769",
            "fax_number": "541-668-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-11-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "541-604-0548",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zuleka Alison Bliss
• John D Blizzard, MD
• Ryan Bloodworth
• Bloom Support Services, LLC (Bloom Support Services)
• Colin Bloom, CADC-R, PSS
• Blue Pine Therapy
• Blue Star Naturopathic Clinic PC
• Bethany Michelle Blumenchein
• Megan Blunda, M.D.
• Richard H Bochner, M.D.

• Pediatric Occupational Therapist in Bend, OR
• Providers in Bend, OR by specialty
• Pediatric Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.