Bloom Primary Mo, LLC
NPI 1093667750 · Family Medicine Physician · Saint Louis, MO
Bloom Primary Mo, LLC is a Family Medicine Physician organization in Saint Louis, MO (NPI 1093667750).
Provider details
- NPI number
- 1093667750
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Debra Moon-Wadelton, Revenue Cycle Manager(720) 923-1250
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
Registry dates
- Enumerated
- 2026-02-13
- Last updated
- 2026-02-13
- Certified
- 2026-02-13
Frequently asked questions
- What is Bloom Primary Mo, LLC's NPI number?
- Bloom Primary Mo, LLC's National Provider Identifier (NPI) is 1093667750, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bloom Primary Mo, LLC?
- Bloom Primary Mo, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Bloom Primary Mo, LLC located?
- Bloom Primary Mo, LLC's practice location on file with NPPES is 540 Maryville Centre Dr Ste 340, Saint Louis, MO 63141-5831.
- What is Bloom Primary Mo, LLC's phone number?
- The practice phone number listed in the NPPES registry for Bloom Primary Mo, LLC is (720) 923-1250.
- Who is the authorized official for Bloom Primary Mo, LLC?
- The authorized official listed on Bloom Primary Mo, LLC's NPPES record is Debra Moon-Wadelton, Revenue Cycle Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bloom Primary Mo, LLC's NPI active?
- Yes — Bloom Primary Mo, LLC's NPI (1093667750) is active in the NPPES registry as of the last update on 2026-02-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.