Blossom North, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2701356N Issued in NY

Legal business name

BLOSSOM NORTH, LLC

Practice address

1335 Portland Ave
Rochester, NY 14621-2706

Phone

(585) 544-4000

Fax

(585) 544-4440

NPI assigned

Dec 18, 2006

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 North Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1760545362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212706",
            "telephone_number": "585-544-4000",
            "fax_number": "585-544-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146212706",
            "telephone_number": "585-544-4000",
            "fax_number": "585-544-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM NORTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-09-13",
        "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": "2701356N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "182720CI",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00355555",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom North Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paige Catherine Worden Bloom, NP
• Penny Ann Bloom, RN
• Molly Bloomenthal
• Blossom Health Care Center, Inc.
• Blossom North
• Blossom Road Medicine, PLLC
• Blossom South, LLC
• Linda Blossom, P.T.
• Yveline Blot, MD
• Brittany Rose Blount, PA

• 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 Sep 13, 2011; 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.