ROGER EARL BLOOMER (NPI# 1235196486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235196486 |
| Entity Type | Individual |
| Full Name | ROGER EARL BLOOMER |
| Credential | MD |
| Practice Address |
2200 Springport Rd Ste 500 Jackson MI 49202 |
| Mailing Address |
Department 272801 Po Box 67000 Detroit MI 48267-2728 |
| Practice Telephone | 5172053273 |
| Practice Fax Number | 5172051698 |
| Mailing Telephone | 5178416913 |
| Mailing Fax Number | 5178416917 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2018-06-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 4301075147 | MI | Allopathic & Osteopathic Physicians |
| Y | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
4301075147 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 104578484 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 153 Wamplers Lake Rd, Brooklyn, MI 492309585 | 5175921963 | 5175921967 |
| Street Address |
2200 SPRINGPORT RD STE 500 |
| City | JACKSON |
| State | MI |
| Zip Code | 49202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538538251 | Mallorie Kettlehut | Nurse Practitioner | 2200 Springport Rd Ste 500, Jackson, MI 49202-1432 | 2015-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 2083P0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Undersea and Hyperbaric Medicine |
| A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide poisoning, gas gangrene, non-healing wounds, tissue damage from radiation and burns and bone infections. This specialist also serves as consultant to other physicians in all aspects of hyperbaric chamber operations and assesses risks and applies appropriate standards to prevent disease and disability in divers and other persons working in altered atmospheric conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518404466 | W.a. Foote Memorial Hospital, Inc | Preventive Medicine | 205 N. East Ave, Jackson, MI 49201 | 2017-01-30 |
| 1891880621 | Ms Wound Care | Preventive Medicine | 1225 N State St, Jackson, MS 39202-2064 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396104303 | Healing and Restoring Pllc | Preventive Medicine | 8704 N. Bluffview Drive, Berrien Springs, MI 49103 | 2016-02-18 |
| 1891108148 | Healing and Restoring Pllc | Preventive Medicine | 44 Longmeadow Ln, Niles, MI 49120-7802 | 2014-06-04 |
| 1922440478 | Spectrum Health Hospitals | Preventive Medicine | 1208 W Oak St, Greenville, MI 48838-2155 | 2013-07-25 |
| 1922286061 | Dr. Steven M. Pearl Md | Preventive Medicine | 35550 Central City Pkwy, Westland, MI 48185 | 2008-01-31 |
| 1083788285 | Sharon Anne Rooney-gandy | Preventive Medicine | 42 N Saint Joseph Ave Ste 103, Niles, MI 49120-2203 | 2006-11-20 |
| 1881201879 | Oxford Recovery Center | Preventive Medicine | 7030 Whitmore Lake Rd, Brighton, MI 48116-8533 | 2020-09-24 |
| 1497125157 | Healogics Specialty Physicians of Michigan, Pllc | Preventive Medicine | 2333 Biddle Ave, Wyandotte, MI 48192-4668 | 2015-10-06 |
| 1255444907 | Edward David Lanigan | Preventive Medicine | 42 N Saint Joseph Ave, Suite 103, Niles, MI 49120-2203 | 2006-08-16 |
Please comment or provide details below to improve the information on ROGER EARL BLOOMER.
| 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.