BLOOM CENTER FOR PEDIATRIC THERAPY (NPI# 1215397666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215397666 |
| Entity Type | Organization |
| Organization Name | BLOOM CENTER FOR PEDIATRIC THERAPY |
| Practice Address |
7677 W Portneuf Rd Pocatello ID 83204-7336 |
| Practice Telephone | 2086046260 |
| Mailing Telephone | 2086046260 |
| Enumeration Date | 2016-02-27 |
| Last Update Date | 2016-04-04 |
| Authorized Official Name | MRS. MICHELLE LEE LANCE (OWNER/SPEECH LANGUAGE PATHOLOGIST) |
| Authorized Official Telephone | 2086046260 |
| Authorized Official Credential | M.S. CCC-SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | SLP-2171 | ID | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MICHELLE LANCE | 1417261645 | 01 |
| ID | KRISTA HALE | 1578871505 | 01 |
| Street Address |
7677 W PORTNEUF RD |
| City | POCATELLO |
| State | ID |
| Zip Code | 83204-7336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447732359 | Ashley Lynne Jones | Occupational Therapy Assistant | 7677 W Portneuf Rd, Pocatello, ID 83204 | 2018-09-06 |
| 1487140810 | Kirsten Adams | Speech-Language Pathologist | 7677 W Portneuf Rd, Pocatello, ID 83204-7336 | 2018-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568974541 | Daniel Graham Rasmussen | Social Worker | 335 N. Main, Pocatello, ID 83204 | 2017-10-30 |
| 1801311246 | Thomas Henrie | Specialist/Technologist | 3960 Stockman Rd., Pocatello, ID 83204 | 2017-08-07 |
| 1750803110 | David Tim Williams | Counselor | 224 S. Arthur Suite 2, Pocatello, ID 83204 | 2017-07-07 |
| 1023441185 | Insight Occupational Therapy, LLC | Occupational Therapist | 158 N Main St., Pocatello, ID 83204 | 2013-08-13 |
| 1679816912 | A New Hope, LLC | Day Training, Developmentally Disabled Services | 19b Mountain Dr, Pocatello, ID 83204 | 2013-04-05 |
| 1790032431 | Wynnona Sarah Warren | Pharmacist | 911 North Main Street, Pocatello, ID 83204 | 2012-08-13 |
| 1902110380 | Belmont Management, Inc. | Intermediate Care Facility, Mentally Retarded | 6150 S. 5th Ave, Pocatello, ID 83204 | 2010-07-28 |
| 1104066539 | Rachel Ann Seibold | Speech-Language Pathologist | 1254 Swisher Rd, Pocatello, ID 83204 | 2009-02-25 |
| 1710163803 | Allen Bennett Martin | Clinic/Center | 540 South Garfield, Pocatello, ID 83204 | 2008-01-18 |
| 1174711758 | Rsm Pa Pllc | Physician Assistant | 1595 Bannock Hwy, Pocatello, ID 83204 | 2007-10-09 |
| Find all providers in zip 83204 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528624673 | Casey's Specialty Speech, LLC | Speech-Language Pathologist | 920 Deon Dr Ste E, Pocatello, ID 83201-3069 | 2019-05-14 |
| 1235584939 | Patricia Taylor | Speech-Language Pathologist | 5170 W Yarrow Rd, Pocatello, ID 83201-9028 | 2016-04-30 |
| 1578871505 | Krista Jean Hale | Speech-Language Pathologist | 1045 Homerun St, Pocatello, ID 83202-1616 | 2010-09-24 |
| 1447567144 | Marcia Williams | Speech-Language Pathologist | 1110 Call Creek Dr Ste 4b, Pocatello, ID 83201-3072 | 2010-09-02 |
| 1417261645 | Michelle Lee Lance | Speech-Language Pathologist | 13345 W Reservation Rd, Pocatello, ID 83202-5131 | 2010-07-29 |
| 1114239803 | Hollie Jo Bowman | Speech-Language Pathologist | 1322 W Syphon Rd, Pocatello, ID 83204-7436 | 2010-07-09 |
| 1952631459 | Gunda Jones | Speech-Language Pathologist | 495 Kurtwood Dr, Pocatello, ID 83204-3556 | 2010-01-05 |
| 1104066539 | Rachel Ann Seibold | Speech-Language Pathologist | 1254 Swisher Rd, Pocatello, ID 83204 | 2009-02-25 |
| 1891959235 | Jacie Jean Pollard | Speech-Language Pathologist | 1110 Call Creek Dr, Suite #7, Pocatello, ID 83201-3072 | 2008-07-15 |
| 1053519751 | Cheryl Zaremba | Speech-Language Pathologist | 896 Lucille Ave, Pocatello, ID 83201-2618 | 2007-07-05 |
| Find all providers in POCATELLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.