Blossom Valley Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BLOSSOM VALLEY BEHAVIORAL HEALTH, LLC

Practice address

25 N Wenatchee Ave Ste 207a
Wenatchee, WA 98801-2283

Phone

(509) 253-5881

Fax

(509) 960-9470

NPI assigned

Sep 23, 2022

Last updated

Feb 3, 2023By 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

Mrs. Brandi Jo Larson, ARNPNPI 1659912780

Title

Owner

Phone

(509) 253-5881

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

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.

• Brandi Jo Larson

  • Psychiatric/Mental Health Nurse Practitioner
  • Wenatchee, WA
  • NPI 1659912780
  Medicare reassignment NPD Authorized official
• Tess Astley

  • Family Nurse Practitioner
  • Wenatchee, WA
  • NPI 1063131274

  Single Specialty

  NPD
• Jared Paul Wagner, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Wenatchee, WA
  • NPI 1528228103
  NPD
• Theodore Andrew Manos, M.D.

  • Anesthesiology Physician
  • Scottsdale, AZ
  • NPI 1346270063
  NPD (past)

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1982327912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 W RIVERSIDE AVE STE N",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010580",
            "telephone_number": "509-253-5881",
            "fax_number": "509-960-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 N WENATCHEE AVE STE 207A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012283",
            "telephone_number": "509-253-5881",
            "fax_number": "509-960-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM VALLEY BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-23",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "BRANDI",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-253-5881",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2142419",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Blankenship
• Beth Loraine Blankenship, PA-C
• Blanksma Chiropractic Clinic
• Pete L Blanksma, D.C.
• David C Blood, MD
• Blossom Valley Wenatchee
• Fred P Bockenstedt, MD
• Mabel Amelia Bodell, MD
• Krista Miller Bodrey, M.D.
• Daniel Boers, DDS, MPH

• Psychiatric/Mental Health Nurse Practitioner in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.