BLOOM PRIMARY MO II, LLC
NPI 1417871013
Internal Medicine in Saint Louis, MO
About Bloom Primary Mo Ii, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLOOM PRIMARY MO II, LLC (NPI 1417871013) is a healthcare organization registered as an internal medicine in Saint Louis, Missouri and active in the NPI registry since August 2026. The organization lists Debra Kay Moon Wadelton, Authorized Official, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Primary Mo II, LLC's NPI number?
The NPI number for Bloom Primary Mo II, LLC is 1417871013. It was assigned to this organization in the NPPES registry on August 6, 2026.
Where is Bloom Primary Mo II, LLC located?
Bloom Primary Mo II, LLC is located at 540 Maryville Centre Dr Ste 340, Saint Louis, MO 63141. The listed phone number is (303) 993-1330.
What is Bloom Primary Mo II, LLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
When was this NPI record last updated?
The NPPES record for Bloom Primary Mo II, LLC was last updated on August 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days 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.