Bloom Speech & Neuro Rehab, LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

BLOOM SPEECH & NEURO REHAB, LLC

Practice address

9422 S Elwood Ave Ste 100
Jenks, OK 74037-2317

Phone

(918) 869-6379

Fax

(918) 627-7896

NPI assigned

Jun 17, 2025

Last updated

Jun 17, 2025By 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

Ashlie Nidiffer-Tull, MA., CCC-SLP

Title

Owner and SLP

Phone

(918) 869-6379

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Ashlie Whitten, SLP

  • Speech-Language Pathologist
  • Jenks, OK
  • NPI 1528741667
  NPD

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

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750118400000",
    "number": "1730075474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9422 S ELWOOD AVE STE 100",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372317",
            "telephone_number": "918-869-6379",
            "fax_number": "918-627-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9422 S ELWOOD AVE STE 100",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372317",
            "telephone_number": "918-869-6379",
            "fax_number": "918-627-7896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 S Maple St",
            "address_purpose": "LOCATION",
            "city": "Glenpool",
            "state": "OK",
            "postal_code": "740332310",
            "country_code": "US",
            "telephone_number": "918-869-6379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BLOOM SPEECH & NEURO REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A",
        "authorized_official_last_name": "NIDIFFER-TULL",
        "authorized_official_first_name": "ASHLIE",
        "authorized_official_title_or_position": "OWNER AND SLP",
        "authorized_official_telephone_number": "918-869-6379",
        "authorized_official_credential": "MA., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandeep K Bhatia, M.D.
• Jayden Victoria Blackwell
• Casey Blair
• Mycah Blanton
• Bloom School Based Therapy
• Blooming Mind PLLC
• Blue Lotus Therapeutic Services, PC
• Megan Bosch
• Crystal Michelle Bowen
• Gwendolyn Ann Boyd, OTR

• Hearing and Speech Clinic/Center in Jenks, OK
• Providers in Jenks, OK by specialty
• Hearing and Speech Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; 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.