JENNIFER R BLOOM (CNP) – Adult Health Nurse Practitioner, NPI 1881724284
Adult Health Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
14,984 NURSE PRACTITIONER in OH
Provider Addresses for JENNIFER R BLOOM (CNP)
4201 WOODBINE AVE
DAYTON, OH 454202751
Phone: (937) 252-2411
Type: Mailing
324 WILMINGTON AVE
DAYTON, OH 454201890
Phone: (937) 416-1537
Type: Location
3120 Governors Place Blvd
Kettering, OH 454091328
Phone: (937) 293-1622
Fax: (937) 245-6308
Type: Location
501 Atrium Dr Fl 1
Middletown, OH 450055165
Phone: (937) 293-1622
Fax: (937) 245-6308
Type: Location
855 W Market St
Troy, OH 453733837
Phone: (937) 293-1622
Fax: (937) 245-6308
Type: Location
6680 POE AVE STE 200
DAYTON, OH 454142855
Phone: (937) 280-8400
Type: Mailing
8881 N MAIN ST
DAYTON, OH 454151333
Phone: (937) 293-1622
Fax: (937) 245-6308
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 36 Open Payments records for all available years, with a total value of $754.
Total Amount is formed as General ($754) + Research ($0) + Ownership ($0) = $754.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($144).
Total Amount
$754
General + Research + Ownership
Payments
36
Total payment records
General Amount
$754
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-03-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240301000778 | I | Nurse Practitioner | OH | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 45420)
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