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BLOOM AT WILLOW, LLC
NPI 1669255931
Assisted Living Facility in Indianapolis, IN

Active since August 18, 2023CLIA 15D1002918 · Waiver
2725 LAKE CIRCLE DR, INDIANAPOLIS, IN 46268(317) 334-9400 Get Directions Write a Review

NPPES record last updated: August 18, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Bloom At Willow, Llc NPPES

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

BLOOM AT WILLOW, LLC (NPI 1669255931) is a healthcare organization registered as an assisted living facility in Indianapolis, Indiana and active in the NPI registry since August 2023. The organization holds a CLIA Waiver certificate valid through August 18, 2026 and lists Scott Kantor, President, as its authorized official.

NPPES Registry Identity

NPI1669255931
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBLOOM AT WILLOW, LLC
Location Address2725 LAKE CIRCLE DRIndianapolis, IN 46268-4931
Mailing Address260 E Brown St Ste 315Birmingham, MI 48009-6232
Phone(317) 334-9400
Organization SubpartNo
Authorized OfficialScott KantorPresident · (312) 282-4050
Enumeration DateAugust 18, 2023
NPPES CertifiedAugust 18, 2023
✔ NPI 1669255931 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.

2725 LAKE CIRCLE DR, Indianapolis, IN 46268
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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 15D1002918

Bloom At Willow · Indianapolis, IN
Active · expires Aug 18, 2026
CLIA Number15D1002918
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 19, 2024
Certificate Expiration DateAugust 18, 2026
Laboratory DirectorJames P. Kesler
Laboratory Phone(317) 334-9400
Laboratory LocationBloom At Willow2725 Lake Circle Dr, Indianapolis, IN 46268
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 2

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

SHWETA KHANNA
Physical Therapist
2725 LAKE CIRCLE DR
INDIANAPOLIS, IN 46268
Marion County (317) 315-5294
KORY ANN THOMAS
Physical Therapist
2725 LAKE CIRCLE DR
INDIANAPOLIS, IN 46268
Marion County (812) 870-2307

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 Willow, LLC's NPI number?

The NPI number for Bloom At Willow, LLC is 1669255931. It was assigned to this organization in the NPPES registry on August 18, 2023.

Where is Bloom At Willow, LLC located?

Bloom At Willow, LLC is located at 2725 Lake Circle Dr, Indianapolis, IN 46268. The listed phone number is (317) 334-9400.

What is Bloom At Willow, LLC's specialty?

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

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

Yes. A Certificate of Waiver (number 15D1002918) is associated with this NPI, valid through August 18, 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 Willow, LLC was last updated on August 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.