Bernice K Bloom, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT2570 Issued in GA

Practice address

11490 Alpharetta Hwy
Suite 200
Roswell, GA 30076-3811

Phone

(770) 740-8592

Fax

(770) 752-9478

NPI assigned

Dec 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Bernice Katzen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1912075730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11490 ALPHARETTA HWY",
            "address_2": "SUITE 200",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763811",
            "telephone_number": "770-740-8592",
            "fax_number": "770-752-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOM",
        "first_name": "BERNICE",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT2570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BERNICE",
            "last_name": "KATZEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Sara R Block, CCC-SLP
• Ingrid Lea Bloomfield, NURSE PRACTITIONER
• Priti Shah Bloor, DDS
• Blue Line Medical Products, LLC
• Blue Summit Hospice and Palliative Care of Roswell LLC
• Blue Summit Palliative Care LLC

• Physical Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.