BLOOM OF JONESBORO, LLC
NPI 1770061038
Physical Therapist - Pediatrics in Jonesboro, AR

Q: What is Bloom Of Jonesboro, LLC's NPI number?

The NPI number for Bloom Of Jonesboro, LLC is 1770061038. It was assigned to this organization in the NPPES registry on July 30, 2018.

Q: What is Bloom Of Jonesboro, LLC's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Pediatrics, with taxonomy code 2251P0200X.

Active since July 30, 2018

1007 WINDOVER RD STE A, JONESBORO, AR 72401(870) 919-3141(870) 931-6599 Get Directions Write a Review

NPPES record last updated: July 30, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Bloom Of Jonesboro, Llc NPPES

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

BLOOM OF JONESBORO, LLC (NPI 1770061038) is a healthcare organization registered as a pediatrics in Jonesboro, Arkansas and active in the NPI registry since July 2018. The organization lists Jocelyn Johnson, Incorporator, as its authorized official.

NPPES Registry Identity

NPI1770061038

Entity TypeOrganization

Primary Taxonomy2251P0200X

Legal Business NameBLOOM OF JONESBORO, LLC

Location Address1007 WINDOVER RD STE AJonesboro, AR 72401-6009

Mailing Address188 County Road 133Bono, AR 72416-8084 · (870) 919-3141 · Fax (870) 520-6055

Phone(870) 919-3141

Fax(870) 931-6599

Organization SubpartNo

Authorized OfficialJocelyn JohnsonIncorporator · (870) 919-3141

Enumeration DateJuly 30, 2018

✔ NPI 1770061038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · PediatricsRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251P0200X

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, genetics, biomechanics, neurological function, neuroscience, and pathology, behavioral sciences, and understanding of diseases or conditions that necessitate physical therapy care, that affect systems that in turn necessitate physical therapy care (comorbidities), and that influence the type of intervention that can be given.

1007 WINDOVER RD STE A, Jonesboro, AR 72401

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Other Identifiers 1

MedicaidAPPLYINGAR

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

Other Providers at the Same Location NPPES 10

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

ELIZABETH KINCANNON

Occupational Therapist