NPIMap

Organization Active NPI

Bloom Behavioral Solutions

Doing business as Bloom Rehabilitative Services

  • Multi-Specialty Clinic/Center
  • Atlantic Beach, FL
National Provider Identifier
1780088609
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BLOOM BEHAVIORAL SOLUTIONS
Doing business as
Bloom Rehabilitative Services
Practice address
997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone
(904) 647-1849
Fax
(904) 647-2625
NPI assigned
Oct 21, 2014
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BLOOM BEHAVIORAL SOLUTIONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Genevieve Hickey CovingtonNPI 1699083667
Title
Ceo
Phone
(904) 647-1849

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311

Mailing address

997 Atlantic Blvd
Atlantic Beach, FL 32233-3311
Phone (904) 647-1849

Other names 1

  • Bloom Rehabilitative Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bloom Behavioral Solutions2 organizations share this tax ID, including this one
Part of
Bloom Behavioral Solutions

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9141 Cypress Green Dr
Ste 2
Jacksonville, FL 32256
Phone (844) 728-4929

Practitioners & affiliated clinicians

Practitioners 65

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.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1780088609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "997 ATLANTIC BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322333311",
            "telephone_number": "904-647-1849",
            "fax_number": "904-647-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM BEHAVIORAL SOLUTIONS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLOOM BEHAVIORAL SOLUTIONS",
        "enumeration_date": "2014-10-21",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "HICKEY COVINGTON",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-647-1849"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bloom Rehabilitative Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlantic Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 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.