Bloom Center for Pediatric Therapy, LLC
NPI 1215397666ActiveOrganization· Speech-Language Pathologist· Pocatello, ID
Speech-Language Pathologist in Pocatello, Idaho, registered in NPPES in February 2016. The authorized official on file is Michelle Lee Lance, M.S. CCC-SLP, Owner/Speech Language Pathologist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1215397666 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 27, 2016 |
| Last updated in NPPES | Apr 16, 2026 |
| Certified by provider | Apr 16, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | SLP-2171 | ID |
| Physical Therapist | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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