| Bloom Idaho Llc | |
|
6965 N Glenwood St Garden City ID 83714-1967 | |
| (208) 853-3000 | |
| Not Available |
| Full Name | Bloom Idaho Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6965 N Glenwood St, Garden City, Idaho |
| Authorized Official Name and Position | Spencer Smith (CEO) |
| Authorized Official Contact | 2088533000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom Idaho Llc 50 Henry St Cortez CO 81321-3012 Ph: () - | Bloom Idaho Llc 6965 N Glenwood St Garden City ID 83714-1967 Ph: (208) 853-3000 |
| NPI Number | 1679134126 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 05/02/2022 |
| Medicare PECOS PAC ID | 2466782453 |
|---|---|
| Medicare Enrollment ID | O20190917003533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679134126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Murry Sturkie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700825122 PECOS PAC ID: 9234197997 Enrollment ID: I20060505000365 |
| Provider Name | Kirk A Campana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205819950 PECOS PAC ID: 5597717504 Enrollment ID: I20140602000727 |
| Provider Name | Ginger L Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659872000 PECOS PAC ID: 3779828165 Enrollment ID: I20181212002211 |
| Provider Name | Jennifer D Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538631189 PECOS PAC ID: 7214278704 Enrollment ID: I20190410001420 |
| Provider Name | Mindy Lee Degeus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316589278 PECOS PAC ID: 1557793569 Enrollment ID: I20191113001238 |
| Provider Name | Megan Brands |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760003438 PECOS PAC ID: 1951724764 Enrollment ID: I20200713002787 |
| Provider Name | Anthony Bruce Reece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124660931 PECOS PAC ID: 0941612303 Enrollment ID: I20201209002126 |
| Provider Name | Debbie Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194118836 PECOS PAC ID: 5597012898 Enrollment ID: I20201210002282 |
| Provider Name | Majla Husic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083379119 PECOS PAC ID: 1951790906 Enrollment ID: I20211111002575 |
| Provider Name | Kimberley Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659806941 PECOS PAC ID: 8022407030 Enrollment ID: I20211112001784 |
| Provider Name | Tabetha Hoadley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659031193 PECOS PAC ID: 5294128575 Enrollment ID: I20220209000974 |
| Provider Name | Kara Sue Lilya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831840214 PECOS PAC ID: 4880087196 Enrollment ID: I20220209002400 |
| Provider Name | Kiley Alyse Zeitler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528710613 PECOS PAC ID: 5890188734 Enrollment ID: I20220217000186 |
| Provider Name | Tamra Katherine Geryk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487220380 PECOS PAC ID: 3779977392 Enrollment ID: I20220224002478 |
Healing Touch Osteopathic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10199 W Carlton Bay Dr, Garden City, ID 83714 Phone: 208-488-8408 | |
Cottonwood Family Medicine Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5999 W State St Ste B, Garden City, ID 83703 Phone: 208-995-2875 Fax: 208-995-2874 | |
Alliance Medical Group, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10482 W Carlton Bay Dr, Garden City, ID 83714 Phone: 208-955-6500 Fax: 208-955-6503 | |
Alliance Medical Group, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5601 W. Chinden Blvd., Garden City, ID 83714 Phone: 208-809-2865 Fax: 208-809-2866 |