DR. KURT BLOOMSTRAND (NPI# 1710326350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710326350 |
| Entity Type | Individual |
| Full Name | DR. KURT BLOOMSTRAND |
| Credential | MD |
| Practice Address |
1400 W Park St Presence Covenant Medical Center Urbana IL 61801-2334 |
| Practice Telephone | 2173372000 |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2016-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 125.062907 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1400 W PARK ST PRESENCE COVENANT MEDICAL CENTER |
| City | URBANA |
| State | IL |
| Zip Code | 61801-2334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801862461 | Shamim Sadiq | Internal Medicine | 1400 W Park St, Urbana, IL 61801-2334 | 2006-02-24 |
| 1548873938 | Audra Leigh Cisna | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-08-26 |
| 1689200750 | Holly Tompkins | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801-2334 | 2020-03-20 |
| 1417419045 | Latifa Omran | Technician/Technologist | 1400 W Park St, Urbana, IL 61801-2334 | 2019-04-02 |
| 1588134084 | Lauren Dowd | Dietitian, Registered | 1400 W Park St, Urbana, IL 61801 | 2018-11-28 |
| 1053801514 | Sarah Kristine Farison | Speech-Language Pathologist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
| 1316437882 | Tian Lan | Physical Therapist | 1400 W Park St, Urbana, IL 61801-2334 | 2018-05-10 |
| 1659884476 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| 1093228835 | Osf Healthcare System | Ambulance | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| 1649783473 | Osf Healthcare System | General Acute Care Hospital | 1400 W Park St, Urbana, IL 61801 | 2017-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1922617133 | Recovery Concepts Urbana, LLC | Clinic/Center | 710 W. Killarney St., Urbana, IL 61801 | 2020-07-24 |
| 1447877089 | Muhammad Khalid Abbas | Internal Medicine | 611 W Park St Urbana, Urbana, IL 61801 | 2020-06-30 |
| 1003430166 | Conlan Joseph Pierce | Surgery | 601 W Park St, Urbana, IL 61801 | 2020-06-04 |
| 1568090900 | Luke Andrew Fenlon | Student in an Organized Health Care Education/Training Program | Carle Forum Lower Level, Mc-474, 611 West Park Street, Urbana, IL 61801 | 2020-03-31 |
| 1912559691 | Ali Baltaji | Internal Medicine | 101 N Busey Apt 7, Urbana, IL 61801 | 2019-07-12 |
| 1821510918 | Pallavi Pradeep | Internal Medicine | Imrp, Carle Foundation Hospital, 611 W Park Street, Urbana, IL 61801 | 2017-07-11 |
| 1093236002 | Angela Lynn Devaney | Speech-Language Pathologist | 1400 W Park, Presence Covenant Medical Center, Urbana, IL 61801 | 2017-06-29 |
| 1346775236 | Jennifer Garcia | Student in an Organized Health Care Education/Training Program | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2017-04-27 |
| 1467992537 | Amber Kristine Davis | Speech-Language Pathologist | 1400 W. Park, Presence Health Medical Center, Urbana, IL 61801 | 2017-03-08 |
| Find all providers in zip 61801 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669438198 | Napoleon B Knight | Emergency Medicine | 611 W Park Street, Emergency Medicine, Urbana, IL 61801 | 2006-04-24 |
| 1811966781 | William (brad) B Weir | Emergency Medicine | 611 W. Park Street, Emergency Medicine, Urbana, IL 61801 | 2006-03-14 |
| 1407858871 | Spfld Urb Emergency Physicians Inc | Emergency Medicine | 904 Scioto St, Urbana, OH 43078-2226 | 2005-08-15 |
| 1083144232 | Brendan Mcevoy | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2512 | 2017-06-19 |
| 1790135499 | Zakaria Abdulnabi | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2016-06-14 |
| 1104292150 | Lars Grant | Emergency Medicine | 1400 W Park St, Emergency Department, Urbana, IL 61801-2334 | 2015-08-13 |
| 1366857906 | Eric S Toone | Emergency Medicine | 611 W. Park St., Emergency Med., Urbana, IL 61801-2500 | 2014-06-23 |
| 1053750935 | Imran Khan | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2013-06-24 |
| 1477997369 | Clinton R Holaday | Emergency Medicine | 611 W Park St, Urbana, IL 61801-2529 | 2013-04-22 |
| 1174874291 | Syed Ahmed Waqar Jafri | Emergency Medicine | 611 W. Park St., Ed, Urbana, IL 61801-2500 | 2012-09-28 |
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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.