BLOOM MENTAL HEALTH LLC (NPI# 1427693613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427693613 |
| Entity Type | Organization |
| Organization Name | BLOOM MENTAL HEALTH LLC |
| Practice Address |
933 Tommy Munro Dr. Suite C Biloxi MS 39532 |
| Mailing Address |
Po Box 8592 Biloxi MS 39535-8592 |
| Practice Telephone | 2283430325 |
| Mailing Telephone | 2253430325 |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | JENNIFER LEIGH GALLE (OWNER) |
| Authorized Official Telephone | 2283430325 |
| Authorized Official Credential | PMHNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | STATE LICENSE | R864186 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Bloom Mental Health LLC | 26 W Dry Creek Circle, Suite 710, Littleton, CO 80120 |
| Street Address |
933 TOMMY MUNRO DR. SUITE C |
| City | BILOXI |
| State | MS |
| Zip Code | 39532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003397530 | The National Diabetes & Obesity Research Institute At Tradition, Missi | Dietitian, Registered | 19289 St. Joseph Street, Suite C, Biloxi, MS 39532 | 2018-08-23 |
| 1134588999 | Victoria Leonard Scott | Counselor | 6905 Gregory Dr, Biloxi, MS 39532 | 2016-02-22 |
| 1639552490 | Laura O'keefe | Nurse Practitioner | 1720a Medical Park Dr Ste 150, Biloxi, MS 39532 | 2015-06-29 |
| 1659767150 | D'iberville Home Program LLC | Clinic/Center | 14215 Cook Road, Biloxi, MS 39532 | 2015-04-10 |
| 1467842476 | Alicia Michelle Mcdaniel | Nurse Practitioner | 14209 Cook Rd Suite 200, Biloxi, MS 39532 | 2015-01-28 |
| 1437402393 | Lisa Q. Brown | Occupational Therapist | 680 Bay Cove Drive, Residents At Baycove, Biloxi, MS 39532 | 2012-10-17 |
| 1962759381 | Joshua Shumway | Physical Therapist | 220 Ploesti Dr, Keesler Afb, MS 39532 | 2012-08-06 |
| 1386912483 | Polk's Crossgates Discount Drugs Inc. | Pharmacy | 1845 Popps Ferry Road, Biloxi, MS 39532 | 2011-12-05 |
| 1346566957 | Kerri Lyn Manjarrez | Social Worker | 12304 Tiffany Lane, Biloxi, MS 39532 | 2010-04-08 |
| 1164758116 | Annette T. Fertitta | Speech-Language Pathologist | 16237 Old Woolmarket Road, Biloxi, MS 39532 | 2009-10-27 |
| Find all providers in zip 39532 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548514151 | Scott J. Turner | Nurse Practitioner | 400 Veteran Ave., Biloxi, MS 39531 | 2012-11-05 |
| 1841819471 | Tonya Katina Fountain-adams | Nurse Practitioner | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2020-04-14 |
| 1114482429 | Debbie Curtis | Nurse Practitioner | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2019-01-31 |
| 1487134045 | Beau Albanese | Nurse Practitioner | 400 Veterans Ave Bldg 25, Biloxi, MS 39531-2410 | 2018-08-14 |
| 1386134021 | Lauralee Simpsiridis | Nurse Practitioner | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2018-05-17 |
| 1356874903 | Teranika Douglas | Nurse Practitioner | 152 Gateway Dr, Biloxi, MS 39531-4409 | 2017-04-10 |
| 1295181071 | Kati Wijdenes | Nurse Practitioner | 301 Fisher St, Biloxi, MS 39534-2508 | 2016-05-10 |
| 1538572078 | Geri Norskov | Nurse Practitioner | 400 Veterans Ave, Building 25 Floor 2a, Biloxi, MS 39531-2410 | 2014-06-03 |
| 1699844894 | Gregory Lee Taylor | Nurse Practitioner | 400 Veterans Ave, Building 19-2, Biloxi, MS 39531-2410 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861909 | Sheila Ruth Cater Murphy | Nurse Practitioner | 761 Ripley Ave, 761 Ripley Ave, Ashland, MS 38603 | 2020-11-03 |
| 1376157487 | Rebekah N Stallworth | Nurse Practitioner | 5200 Griffin St, Moss Point, MS 39563-2020 | 2020-09-04 |
| 1588278006 | Shayla Lee | Nurse Practitioner | 665 S Pear Orchard Rd Ste 106-591, Ridgeland, MS 39157-4861 | 2020-09-02 |
| 1093329633 | Mary Lindsey Lumley | Nurse Practitioner | 620 Hwy 51, Brookhaven, MS 39601 | 2020-09-01 |
| 1548874159 | Susan Me'chelle Oliver | Nurse Practitioner | 874 Barnes Crossing Road, Tupelo, MS 38804 | 2020-09-01 |
| 1093325409 | Justin Robert Ragon | Nurse Practitioner | 40 Roosters Ln, Carriere, MS 39426-7022 | 2020-07-31 |
| 1467078220 | Scott Drennan | Nurse Practitioner | 2105 Sandalwood Pl, Gautier, MS 39553-7705 | 2020-06-17 |
| 1811511819 | Aretha M. Northington | Nurse Practitioner | 1430 Wingfield Dr., Jackson, MS 39204-4448 | 2020-06-04 |
| 1336770015 | Jamie Alise Mcfarland | Nurse Practitioner | 8752 Cat Tail Dr, Southaven, MS 38671-5072 | 2020-01-30 |
| 1942840996 | Cocetha Belton | Nurse Practitioner | 201 Copper Ridge Way, Florence, MS 39073-4601 | 2020-01-07 |
| Find all providers with the same taxonomy | ||||
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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.