BLOOM AND GROW PEDIATRICS LLC (NPI# 1760956031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760956031 |
| Entity Type | Organization |
| Organization Name | BLOOM AND GROW PEDIATRICS LLC |
| Other Organization Name | BLOOM AND GROW PEDIATRICS |
| Practice Address |
1315 Burro Ave Cloudcroft NM 88317-7719 |
| Mailing Address |
Po Box 1902 Cloudcroft NM 88317-1902 |
| Practice Telephone | 5756822002 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-29 |
| Authorized Official Name | SUSAN BRUCE (OWNER) |
| Authorized Official Telephone | 5759212318 |
| Authorized Official Credential | CPNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 99120330 | 05 | |
| NM | TYPE 1 NPI | 1326276395 | 01 |
| Other Name | Type Code |
|---|---|
| Bloom and Grow Pediatrics | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BLOOM AND GROW PEDIATRICS LLC | 16 Arrow Rd, Cloudcroft, NM 88317-9445 |
| Street Address |
1315 BURRO AVE |
| City | CLOUDCROFT |
| State | NM |
| Zip Code | 88317-7719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326276395 | Susan A Bruce | Nurse Practitioner | 1315 Burro Ave, Cloudcroft, NM 88317-7719 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992043186 | Eva Lynne Budzinski | Nurse Practitioner | 15 East Spur Road, Cloudcroft, NM 88317 | 2013-01-22 |
| 1326115338 | Presbyterian Medical Services | Non-Pharmacy Dispensing Site | 74 James Canyon Hwy, Cloudcroft, NM 88317 | 2006-11-29 |
| 1548277403 | Sylvia M Montoya | Family Medicine | 74 James Canyon Highway, Cloudcroft, NM 88317 | 2006-08-02 |
| 1023429552 | Monica A. Rodriguez | Nurse Practitioner | 93 Little Glorietta, Cloudcroft, NM 88317-0013 | 2014-05-19 |
| 1801243761 | Abigail Head | Behavior Technician | 163 Pierce Canyon Road, Cloudcroft, NM 88317-0287 | 2016-05-20 |
| 1891828554 | Village of Cloudcroft | Ambulance | 1100 James Canyon Hwy, Cloudcroft, NM 88317-0317 | 2007-03-13 |
| 1790837110 | Bradley G. Rasch | Chiropractor | 62 Curlew Pl, Cloudcroft, NM 88317-0650 | 2007-01-17 |
| 1346858420 | Louise Hamilton | Behavior Technician | 1301 Sugar Pine Dr, Cloudcroft, NM 88317-7765 | 2020-07-15 |
| 1770504805 | Gail M Ellison | Nurse Practitioner | 93 Little Glorietta, Cloudcroft, NM 88317-8831 | 2006-07-22 |
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326276395 | Susan A Bruce | Nurse Practitioner | 1315 Burro Ave, Cloudcroft, NM 88317-7719 | 2009-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558960153 | Renea M Reano | Nurse Practitioner | 4701 Irving Blvd Nw Apt 508, Albuquerque, NM 87114-3906 | 2020-10-23 |
| 1104433952 | Joli Ann Martinez | Nurse Practitioner | 2028 Coba Rd Se, Rio Rancho, NM 87124-8913 | 2020-09-25 |
| 1124642772 | Little Steps Pediatrics LLC | Nurse Practitioner | 1990 E Lohman Ave Ste A, Las Cruces, NM 88001-3117 | 2020-05-29 |
| 1558865980 | Kirsten Shelby Guerra | Nurse Practitioner | 4401 E. Lohman Ave ., Suite A, Las Cruces, NM 88011 | 2018-03-21 |
| 1225552094 | Sacheen Diahn Naddy | Nurse Practitioner | 8650 Alameda Blvd Ne # 101, Albuquerque, NM 87122-3791 | 2017-08-02 |
| 1336661958 | Camille Caroline Walker | Nurse Practitioner | 437 Loma Linda Loop Ne, Rio Rancho, NM 87124-4717 | 2017-07-14 |
| 1700242112 | Gustavo Gutierrez | Nurse Practitioner | 800 S County Line Dr, Chaparral, NM 88081 | 2016-01-14 |
| 1689040461 | Elizabeth Rodgers | Nurse Practitioner | 700 Lomas Blvd Ne, 3 Woodward Center, Albuquerque, NM 87102 | 2015-08-17 |
| 1891026563 | Lori Myers | Nurse Practitioner | 1721 Rio Rancho Blvd. Nw, Rio Rancho, NM 87124 | 2010-01-20 |
| 1972833523 | Deborah J Angeles | Nurse Practitioner | 27th Special Operations Medical Group, 224 W Dl Ingram Ave, Cannon Afb, NM 88103-5103 | 2010-01-04 |
| Find all providers with the same taxonomy | ||||
| City | CLOUDCROFT |
| Zip Code | 88317 |
Please comment or provide details below to improve the information on BLOOM AND GROW PEDIATRICS LLC.
| 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.