MS. CARLA BLOEM (NPI# 1033146980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033146980 |
| Entity Type | Individual |
| Full Name | MS. CARLA BLOEM |
| Credential | PA-C |
| Practice Address |
221 W Stewart Ave Suite 101 Medford OR 97501-3609 |
| Practice Telephone | 5417762003 |
| Practice Fax Number | 5417769833 |
| Mailing Telephone | 5417762003 |
| Mailing Fax Number | 5417769833 |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2015-02-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA160148 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
221 W STEWART AVE SUITE 101 |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-3609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578566691 | Philip Y Paden | Ophthalmology | 221 W Stewart Ave, Ste 110, Medford, OR 97501-3647 | 2005-05-23 |
| 1679896278 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 221 W Stewart Ave, Medford, OR 97501-3609 | 2010-03-10 |
| 1407891401 | Jason K Bates | Optometrist | 221 W Stewart Ave, Ste 110, Medford, OR 97501 | 2006-06-17 |
| 1770571200 | Richard L Eddy | Internal Medicine | 221 W Stewart Ave, Suite 101, Medford, OR 97501-3609 | 2005-10-10 |
| 1477549194 | Institute of Diabetes and Endocrinology PC | Internal Medicine | 221 W Stewart Ave, Suite 101, Medford, OR 97501-3609 | 2005-09-27 |
| 1043213143 | Philip Y Paden Eye Care Optical | Eyewear Supplier (Equipment, not the service) | 221 W Stewart Ave, Ste 110, Medford, OR 97501-3647 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932346095 | Elena Tovkan Forster | Physician Assistant | 2924 Siskiyou Blvd Ste 200, Medford, OR 97504 | 2009-01-12 |
| 1245416544 | Alanna R Dixon | Physician Assistant | 1698 E. Mcandrews Rd, Suite 400, Medford, OR 97504-5590 | 2008-01-16 |
| 1134784580 | Amanda Nicole Taylor | Physician Assistant | 2828 E Barnett Rd, Medford, OR 97504-8342 | 2019-05-01 |
| 1295398766 | Lindsey R Robinson | Physician Assistant | 19 Myrtle St, Medford, OR 97504-7337 | 2019-04-19 |
| 1396226247 | Mason Scott Hoying | Physician Assistant | 1698 E Mcandrews Rd Ste 400, Medford, OR 97504-5590 | 2018-08-28 |
| 1720598287 | Ryan Mcdaniel | Physician Assistant | 2780 E Barnett Rd, Medford, OR 97504-8674 | 2017-10-10 |
| 1861946931 | Erica Florence Smith | Physician Assistant | 2825 E Barnett Rd, Medford, OR 97504-8332 | 2016-08-06 |
| 1578933123 | Fred Garnica | Physician Assistant | 503 Airport Rd Ste 101, Medford, OR 97504-4159 | 2015-09-25 |
| 1003297581 | Gregory Lee Werner | Physician Assistant | 143 S Gibson St, Medford, WI 54451-1622 | 2015-06-10 |
| 1780087502 | Dillon Smith | Physician Assistant | 2780 E Barnett Rd Ste 200, Medford, OR 97504 | 2014-10-07 |
| Find all providers in MEDFORD | ||||
Please comment or provide details below to improve the information on MS. CARLA BLOEM.
| 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.