BLOOM PRIMARY MO, LLC – NPI #1093667750
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

BLOOM PRIMARY MO, LLC is a provider located in SAINT LOUIS, MO. NPPES has assigned the NPI number 1093667750 to BLOOM PRIMARY MO, LLC on February 13, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLOOM PRIMARY MO, LLC below.

NPI Profile for
BLOOM PRIMARY MO, LLC

NPI Number
1093667750
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLOOM PRIMARY MO, LLC
Primary location
540 MARYVILLE CENTRE DR STE 340
SAINT LOUIS, MO 63141-5831
Phone: (720) 923-1250 Fax:
Mailing address
12600 W COLFAX AVE STE B200
LAKEWOOD, CO 80215-3736
Phone: (720) 923-1250 Fax:
Organization Subpart
No
Authorized Official
DEBRA MOON-WADELTON
REVENUE CYCLE MANAGER
Phone: (720) 923-1250
Updated
Certification Date
Feb 13, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.