Inbloom, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

INBLOOM, LLC

Practice address

2095 Exeter Rd Ste 80318
Germantown, TN 38138-3963

Phone

(901) 245-0199

NPI assigned

Jun 7, 2024

Organization subpart

No

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

Authorized official

Name

Deona Deicke

Title

Credentialing Manager

Phone

(203) 641-9529

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1717718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1972345205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 BRAYSTONE TRL",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 EXETER RD STE 80318",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383963",
            "telephone_number": "901-245-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INBLOOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-07",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "DEICKE",
        "authorized_official_first_name": "DEONA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "203-641-9529"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Germantown, TN
• Providers in Germantown, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.