DR. JEANNIE BLOM (NPI# 1295707107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295707107 |
| Entity Type | Individual |
| Full Name | DR. JEANNIE BLOM |
| Credential | MD |
| Practice Address |
2722 N Decatur Rd Decatur GA 30033-5910 |
| Mailing Address |
Po Box 190218 Atlanta GA 31119-0218 |
| Practice Telephone | 4048493443 |
| Practice Fax Number | 4046001099 |
| Mailing Telephone | 4048493443 |
| Mailing Fax Number | 4046001099 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2015-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
041517 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
2722 N DECATUR RD |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-5910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326649351 | Ouida Deedra Carr | Nurse Practitioner | 2722 N Decatur Rd, Decatur, GA 30033-5910 | 2020-11-05 |
| 1699304881 | Linda Octavien | Nurse Practitioner | 2722 N Decatur Rd, Decatur, GA 30033-5910 | 2020-04-08 |
| 1922565076 | Glenna Green | Nurse Practitioner | 2722 N Decatur Rd, Decatur, GA 30033-5910 | 2019-02-25 |
| 1609823186 | Manor Care Rehabilitation Center of Decatur Ga LLC | Skilled Nursing Facility | 2722 N Decatur Rd, Decatur, GA 30033-5910 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417093717 | Carol Cobb | Physical Medicine & Rehabilitation | 2315 Old Northpark Ln, Alpharetta, GA 30004-3628 | 2007-01-30 |
| 1518012848 | Pediatric Therapy Services | Physical Medicine & Rehabilitation | 11660 Alpharetta Hwy Ste 540, Roswell, GA 30076 | 2007-01-25 |
| 1215926316 | Rochelle Cotliar | Physical Medicine & Rehabilitation | 100 Lacy St Nw, Suite 150, Marietta, GA 30060-1113 | 2005-10-20 |
| 1720609100 | Kimberly Bray | Physical Medicine & Rehabilitation | 534 Owl Creek Dr, Powder Springs, GA 30127-6285 | 2020-04-27 |
| 1043856479 | Anna Tomes | Physical Medicine & Rehabilitation | 3538 Old Milton Pkwy, Alpharetta, GA 30005-4459 | 2019-11-20 |
| 1952967986 | Joshua Walker Mcwhirter | Physical Medicine & Rehabilitation | 2450 Atlanta Hwy Ste 701, Cumming, GA 30040-1255 | 2019-05-15 |
| 1841581097 | Udayan M. Kulkarni | Physical Medicine & Rehabilitation | 1001 Johnson Fy Rd Ne, Scottish Rites Hospital, Atlanta, GA 30342-1605 | 2011-04-22 |
| 1467658971 | Elizabeth Anne Poplawski | Physical Medicine & Rehabilitation | 1001 Johnson Ferry Rd Ne, Atlanta, GA 30342-1605 | 2007-06-22 |
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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.