Individual provider Active NPI

Jeanne Goldbloom, OTR

  • Occupational Therapist
  • Redmond, WA
National Provider Identifier
1730430604
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 00000954 Issued in WA
Practice address
10906 151St Ave NE
Redmond, WA 98052-2524
Phone
(425) 881-2720
NPI assigned
Oct 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 00000954 WA Primary

Addresses

Primary practice location

10906 151St Ave NE
Redmond, WA 98052-2524

Mailing address

10906 151St Ave NE
Redmond, WA 98052-2524
Phone (425) 881-2720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT 00000954WAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1730430604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10906 151ST AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522524",
            "telephone_number": "425-881-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10906 151ST AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980522524",
            "telephone_number": "425-881-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLOOM",
        "first_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT 00000954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.