Bloom Pediatric Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BLOOM PEDIATRIC THERAPY, LLC

Practice address

1 Avalon Rd
Mount Vernon, OH 43050-1403

Phone

(440) 725-3948

NPI assigned

Jun 13, 2021

Last updated

Dec 21, 2021By 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

Kristen Cantrell, MA CCC-SLPNPI 1902346604

Title

Speech Language Pathologist

Phone

(740) 358-0007

Specialties & licenses 1

Addresses

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.

• Kristen Cantrell, MA, CCC-SLP

  • Speech-Language Pathologist
  • Mount Vernon, OH
  • NPI 1902346604
  NPD Authorized official

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

{
    "created_epoch": "1623542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640044800000",
    "number": "1831767250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 E VINE ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503658",
            "telephone_number": "440-725-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AVALON RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430501403",
            "telephone_number": "440-725-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOM PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-13",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "740-358-0007",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta V Black, D S P
• Amy Blair
• Cassandra L Blair
• Samantha Blanton
• Karen Blocker
• Jonna R Bloomfield, LSW
• Amanda Blubaugh
• Lisa Bockover
• Melissa Ann Bocock
• Melissa Body, LSW/LCDCIII

• Speech-Language Pathologist in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2021; 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.