Blossom North

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

340672 Issued in NY

Legal business name

BLOSSOM NORTH

Practice address

1335 Portland Ave
Rochester, NY 14621-2706

Phone

(585) 544-5000

NPI assigned

Jun 21, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Jacquelyn L Sick, NURSE PRACTITIONER

Title

Nurse Practitioner

Phone

(585) 544-4000

Specialties & licenses 1

Addresses

Other names 1

• Blossom North Rehabilitation Former legal business name

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1912228271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 PORTLAND AVENUE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14621",
            "telephone_number": "585-544-4000"
        },
        {
            "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": "585-544-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM NORTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "SICK",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "585-544-4000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NY",
            "license": "340672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blossom North Rehabilitation",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• 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 Jun 21, 2010; 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.