BLOOM PEDIATRICS OF SOUTHERN IOWA PLLC - NPI 1225974892

Q: What is Bloom Pediatrics Of Southern Iowa PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About Bloom Pediatrics Of Southern Iowa Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOM PEDIATRICS OF SOUTHERN IOWA PLLC (NPI 1225974892) is a healthcare organization registered as a family medicine in Ottumwa, Iowa and active in the NPI registry since April 2026. The organization holds a CLIA Waiver certificate valid through January 3, 2028 and lists Jacy L Kennedy, Arnp, as its authorized official.

NPPES Registry Identity

NPI1225974892

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBLOOM PEDIATRICS OF SOUTHERN IOWA PLLC

Location Address925 CHURCH STOttumwa, IA 52501-4223

Mailing Address925 Church StOttumwa, IA 52501-4223 · (641) 814-5437

Phone(641) 814-5437

Organization SubpartNo

Authorized OfficialJacy L KennedyArnp · (641) 226-8866

Enumeration DateApril 27, 2026

NPPES CertifiedApril 27, 2026

✔ NPI 1225974892 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

925 CHURCH ST, Ottumwa, IA 52501

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 16D2296708

Bloom Pediatrics Of Sutherine Iowa PLLC · Ottumwa, IA

Active · expires Jan 3, 2028

CLIA Number16D2296708

Laboratory TypePhysician Office

Certificate Effective DateJanuary 4, 2026

Certificate Expiration DateJanuary 3, 2028

Laboratory DirectorJacy L. Kennedy

Laboratory Phone(641) 814-5437

Laboratory LocationBloom Pediatrics Of Sutherine Iowa PLLC925 Church St, Ottumwa, IA 52501

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloom Pediatrics Of Southern Iowa PLLC's NPI number?

The NPI number for Bloom Pediatrics Of Southern Iowa PLLC is 1225974892. It was assigned to this organization in the NPPES registry on April 27, 2026.

Where is Bloom Pediatrics Of Southern Iowa PLLC located?

Bloom Pediatrics Of Southern Iowa PLLC is located at 925 Church St, Ottumwa, IA 52501. The listed phone number is (641) 814-5437.

What is Bloom Pediatrics Of Southern Iowa PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Bloom Pediatrics Of Southern Iowa PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D2296708) is associated with this NPI, valid through January 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bloom Pediatrics Of Southern Iowa PLLC was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.