Blossom South, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2701351N Issued in NY

Legal business name

BLOSSOM SOUTH, LLC

Doing business as

Blossom South Nursing and Rehabilitation Center

Practice address

1175 Monroe Ave
Rochester, NY 14620-1613

Phone

(585) 442-0450

Fax

(585) 442-2855

NPI assigned

Dec 18, 2006

Last updated

Jul 19, 2007By 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

Gerald J Wood

Title

Operator

Phone

(516) 679-1500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Blossom South Nursing and Rehabilitation Center Doing business as

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.

• Raymond Arthur Neiswonger, RN, ACNP, BC

  • Critical Care Medicine Nurse Practitioner
  • Buffalo, NY
  • NPI 1326013152
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1750444246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201613",
            "telephone_number": "585-442-0450",
            "fax_number": "585-442-2855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MONROE AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146201613",
            "telephone_number": "585-442-0450",
            "fax_number": "585-442-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPERATOR",
        "authorized_official_telephone_number": "516-679-1500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "2701351N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "183542CI",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355573",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom South Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Molly Bloomenthal
• Blossom Health Care Center, Inc.
• Blossom North
• Blossom North, LLC (Blossom North Nursing and Rehabilitation Center)
• Blossom Road Medicine, PLLC
• Linda Blossom, P.T.
• Yveline Blot, MD
• Brittany Rose Blount, PA
• John L Blount, PTA
• Andrenna Blue

• Skilled Nursing Facility in Rochester, NY
• Providers in Rochester, NY by specialty
• Skilled Nursing Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.