Casey McCary Bloom, D.M.D.
Individual provider Active NPI Dentist · Cullman, AL
NPI 1992856728 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1992856728
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5507 (AL)
- Practice address
- 704 2ND Ave SW
Cullman, AL 35055-4221 - Phone
- (256) 739-5533
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150724009956 | AL | Order and Referring Only - Oral Surgery |
3072826767 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5507 | AL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kari L. Bartlett, DMD, LLC Dba Dental Arts Cullman | Past | Accepting new patients | |
| Thomas a. Barnes, DMD, Dba Dental Arts | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5507 | AL | Yes |
Addresses
Primary practice location
704 2ND Ave SW
Cullman, AL 35055-4221
Mailing address
1305 Easterwood Blvd
Gardendale, AL 35071
Phone (205) 631-1752
Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.