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BLOOM PEDIATRICS
NPI 1750264420
Nurse Practitioner - Pediatrics in Madison, GA

Active since July 29, 2025CLIA 11D2334676 · Waiver
2151 EATONTON RD STE 2, MADISON, GA 30650(770) 595-6394 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bloom Pediatrics NPPES

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

BLOOM PEDIATRICS (NPI 1750264420) is a healthcare organization registered as a pediatrics in Madison, Georgia and active in the NPI registry since July 2025. The organization holds a CLIA Waiver certificate valid through November 25, 2027 and lists Whitney Whitney, Owner, as its authorized official.

NPPES Registry Identity

NPI1750264420
Entity TypeOrganization
Primary Taxonomy363LP0200X
Legal Business NameBLOOM PEDIATRICS
Location Address2151 EATONTON RD STE 2Madison, GA 30650-5088
Mailing Address2965 Doster RdMadison, GA 30650-3501 · (770) 595-6394
Phone(770) 595-6394
Organization SubpartNo
Authorized OfficialWhitney WhitneyOwner · (770) 595-6394
Enumeration DateJuly 29, 2025
Last NPPES UpdateSeptember 16, 2025
NPPES CertifiedSeptember 16, 2025
✔ NPI 1750264420 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
2151 EATONTON RD STE 2, Madison, GA 30650
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 11D2334676

Bloom Pediatrics · Madison, GA
Active · expires Nov 25, 2027
CLIA Number11D2334676
Laboratory TypePractitioner Other
Certificate Effective DateNovember 26, 2025
Certificate Expiration DateNovember 25, 2027
Laboratory DirectorWhitney N. Williams
Laboratory Phone(706) 752-5153
Laboratory LocationBloom Pediatrics2151 Eatonton Road, Suite H2, Madison, GA 30650
CLIA data matches this NPI record on: Name
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's NPI number?

The NPI number for Bloom Pediatrics is 1750264420. It was assigned to this organization in the NPPES registry on July 29, 2025.

Where is Bloom Pediatrics located?

Bloom Pediatrics is located at 2151 Eatonton Rd Ste 2, Madison, GA 30650. The listed phone number is (770) 595-6394.

What is Bloom Pediatrics's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Does Bloom Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2334676) is associated with this NPI, valid through November 25, 2027. 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 was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.