● Active Type 2 · Organization
Bloom Idaho Llc
Clinic/Center·Meridian, ID· NPI 1104401488
·
Enumerated 2021 · 5 years on NPI
Bloom Idaho Llc is 1 of 41 clinic/center organizations in Idaho.
NPI age
5 years
Enumerated 2021-03-17
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Smith
Ceo
Last NPPES update
2022-05-02
Source: monthly bulk 2026-05
How this organization compares
Across 41 active clinic/center providers in Idaho.
NPI age
5 years
≈ at median (5 yr)
Practice locations
1
0 secondary on file
NPI lifetime · 2021 → 2026
2021-03Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
3185 E Ustick Rd
Meridian, ID 83646
📞 2082967100
Mailing address
Po Box 5943
Virginia Beach, VA 234710943
Authorized official
Spencer Smith
Ceo
📞 2088533000
Individual providers at this organization
1 individual provider on file at this primary practice address.
Specialties
-
Clinic/Center
Primary
Definition to come...
taxonomy 261QU0200X
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
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How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.