Bloom Integrative Wellness Center of South Lake, LLC
NPI 1033831227 · Women's Health Nurse Practitioner · Dallas, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bloom Integrative Wellness Center of South Lake, LLC is a Women's Health Nurse Practitioner organization in Dallas, TX (NPI 1033831227).
Provider details
- NPI number
- 1033831227
- Entity type
- Organization
- Primary specialty
- Women's Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Tiffany Reynolds, Ceo(931) 980-1911
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Ambulatory Family Planning Facility261QA0005X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Bloom Integrative Wellness Center
Registry dates
- Enumerated
- 2022-09-14
- Last updated
- 2026-01-27
- Certified
- 2026-01-27
Frequently asked questions
- What is Bloom Integrative Wellness Center of South Lake, LLC's NPI number?
- Bloom Integrative Wellness Center of South Lake, LLC's National Provider Identifier (NPI) is 1033831227, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bloom Integrative Wellness Center of South Lake, LLC?
- Bloom Integrative Wellness Center of South Lake, LLC is classified in the NPPES registry as Women's Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Bloom Integrative Wellness Center of South Lake, LLC located?
- Bloom Integrative Wellness Center of South Lake, LLC's practice location on file with NPPES is 14114 Dallas Pkwy Ste 310, Dallas, TX 75254-1315.
- What is Bloom Integrative Wellness Center of South Lake, LLC's phone number?
- The practice phone number listed in the NPPES registry for Bloom Integrative Wellness Center of South Lake, LLC is (844) 864-8928.
- Does Bloom Integrative Wellness Center of South Lake, LLC accept Medicare?
- Bloom Integrative Wellness Center of South Lake, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Bloom Integrative Wellness Center of South Lake, LLC?
- The authorized official listed on Bloom Integrative Wellness Center of South Lake, LLC's NPPES record is Tiffany Reynolds, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bloom Integrative Wellness Center of South Lake, LLC's NPI active?
- Yes — Bloom Integrative Wellness Center of South Lake, LLC's NPI (1033831227) is active in the NPPES registry as of the last update on 2026-01-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.