| Bloom Geriatrics Llc | |
|
1714 E Hundred Rd Ste 101 Chester VA 23836-3310 | |
| (804) 590-6750 | |
| Not Available |
| Full Name | Bloom Geriatrics Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1714 E Hundred Rd Ste 101, Chester, Virginia |
| Authorized Official Name and Position | Mohammad Farooq (PRESIDENT) |
| Authorized Official Contact | 8045906750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Geriatrics Llc Po Box 11768 Richmond VA 23230-0168 Ph: (804) 590-6750 | Bloom Geriatrics Llc 1714 E Hundred Rd Ste 101 Chester VA 23836-3310 Ph: (804) 590-6750 |
| NPI Number | 1013499623 |
|---|---|
| Provider Enumeration Date | 08/30/2018 |
| Last Update Date | 09/06/2019 |
| Medicare PECOS PAC ID | 9537404967 |
|---|---|
| Medicare Enrollment ID | O20181213000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013499623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Muhammad Ishtiaq Raja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932190451 PECOS PAC ID: 6608899323 Enrollment ID: I20060109000950 |
| Provider Name | Mohammad Farooq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396704581 PECOS PAC ID: 5698711471 Enrollment ID: I20100929000813 |
| Provider Name | Angeline Tonette Gallant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972970150 PECOS PAC ID: 6406165844 Enrollment ID: I20151026000742 |
| Provider Name | Maryann Cheryl Partridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104297118 PECOS PAC ID: 5193026904 Enrollment ID: I20151221002601 |
| Provider Name | Nikitia M Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275990715 PECOS PAC ID: 2466758503 Enrollment ID: I20160315002547 |
| Provider Name | Nataliya Badowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578937934 PECOS PAC ID: 8820395007 Enrollment ID: I20160404000517 |
| Provider Name | Jaimie S Tahir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528420544 PECOS PAC ID: 7719270503 Enrollment ID: I20160802000549 |
| Provider Name | Keisha Q James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235660655 PECOS PAC ID: 8123395282 Enrollment ID: I20170522002081 |
| Provider Name | Delia Esther Acuna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679008973 PECOS PAC ID: 8527333236 Enrollment ID: I20171005002831 |
| Provider Name | Kelly Marsala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649752197 PECOS PAC ID: 1052656766 Enrollment ID: I20181228001130 |
| Provider Name | Mishii Strother Hamlor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669938825 PECOS PAC ID: 1850632985 Enrollment ID: I20190417002808 |
| Provider Name | Elizabeth R Dreher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841684602 PECOS PAC ID: 3173826385 Enrollment ID: I20200506002032 |
| Provider Name | Jerreka Monay Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104415827 PECOS PAC ID: 6204226426 Enrollment ID: I20211202001251 |
Chester Square Family Practice, Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4619 Chester Square Road, Chester, VA 23831 Phone: 804-778-4747 Fax: 804-778-4487 | |
Tri-cities Geriatrics, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1714 E Hundred Rd, Suite 101, Chester, VA 23836 Phone: 804-721-9148 Fax: 804-530-5295 | |
Bon Secours-virginia Healthsource Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11601 Iron Bridge Rd, Suite 117, Chester, VA 23831 Phone: 804-717-5300 Fax: 804-748-7269 | |
Chester Family Medcare Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12901 Briggs Rd, Chester, VA 23831 Phone: 804-796-2373 Fax: 804-748-9160 | |
Premise Health Of Virginia Medical, P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12730 N Kingston Ave, Chester, VA 23836 Phone: 804-787-2550 Fax: 804-787-2555 | |
Bon Secours St. Francis Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12340 Bermuda Crossroad Ln, Chester, VA 23831 Phone: 804-281-0275 Fax: 804-521-9344 |