BLOOM AT KOKOMO, LLC
NPI 1366904872
Assisted Living Facility in Kokomo, IN

Active since April 03, 2019CLIA 15D1062891 · Waiver
2800 S DIXON RD, KOKOMO, IN 46902(765) 455-2828 Get Directions Write a Review

NPPES record last updated: April 3, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bloom At Kokomo, Llc NPPES

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

BLOOM AT KOKOMO, LLC (NPI 1366904872), doing business as Bloom At Kokomo, is a healthcare organization registered as an assisted living facility in Kokomo, Indiana and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through December 28, 2026 and lists Scott Kantor, Owner, as its authorized official.

NPPES Registry Identity

NPI1366904872
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBLOOM AT KOKOMO, LLC
Location Address2800 S DIXON RDKokomo, IN 46902-6403
Mailing Address260 E Brown St Ste 315Birmingham, MI 48009-6232 · (248) 642-2914
Organization SubpartNo
Authorized OfficialScott KantorOwner · (248) 642-2914
Enumeration DateApril 3, 2019
NPI 1366904872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

2800 S DIXON RD, Kokomo, IN 46902

Other Names 1

Doing Business AsBloom At Kokomo

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 15D1062891

Bloom At Kokomo · Kokomo, IN
Active · expires Dec 28, 2026
CLIA Number15D1062891
Laboratory TypeAssisted Living Facility
Certificate Effective DateDecember 29, 2024
Certificate Expiration DateDecember 28, 2026
Laboratory DirectorGary Brent Waymire
Laboratory Phone(765) 455-2828
Laboratory LocationBloom At Kokomo2800 S Dixon Rd, Kokomo, IN 46902
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapy Assistant
2800 S DIXON RD
KOKOMO, IN 46902
Occupational Therapist
2800 S DIXON RD
KOKOMO, IN 46902
Occupational Therapist
2800 S DIXON RD
KOKOMO, IN 46902
Occupational Therapist
2800 S DIXON RD
KOKOMO, IN 46902
Occupational Therapist
2800 S DIXON RD
KOKOMO, IN 46902
Speech-Language Pathologist
2800 S DIXON RD
KOKOMO, IN 46902
Physical Therapy Assistant
2800 S DIXON RD
KOKOMO, IN 46902
Physical Therapist
2800 S DIXON RD
KOKOMO, IN 46902

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 At Kokomo, LLC's NPI number?

The NPI number for Bloom At Kokomo, LLC is 1366904872. It was assigned to this organization in the NPPES registry on April 3, 2019. The provider is doing business as Bloom at Kokomo.

Where is Bloom At Kokomo, LLC located?

Bloom At Kokomo, LLC is located at 2800 S Dixon Rd, Kokomo, IN 46902. The listed phone number is (765) 455-2828.

What is Bloom At Kokomo, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Bloom At Kokomo, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D1062891) is associated with this NPI, valid through December 28, 2026. 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 At Kokomo, LLC was last updated on April 3, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.