Elder Bloom Care LLC

Primary specialty

Nurse's AideTaxonomy code 376K00000X

Legal business name

ELDER BLOOM CARE LLC

Practice address

1143 Old Vintage Rd
Chesapeake, VA 23322-8875

Phone

(757) 401-4799

Fax

(332) 253-5293

NPI assigned

Mar 26, 2024

Organization subpart

No

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

Authorized official

Name

Daphne Amara

Title

Administrator

Phone

(757) 401-4799

Specialties & licenses 3

Addresses

Other names 1

• 22-June-2023 Former legal business name

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1982454518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 OLD VINTAGE RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233228875",
            "telephone_number": "757-401-4799",
            "fax_number": "332-253-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 OLD VINTAGE RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233228875",
            "telephone_number": "757-401-4799",
            "fax_number": "332-253-5293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDER BLOOM CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "AMARA",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-401-4799"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "22-June-2023",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Nurse's Aide in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Nurse's Aide in Virginia

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