Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Ellis Jeremy Bloom, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1124875059

Dr. Ellis Jeremy Bloom, DO is a Student in an Organized Health Care Education/Training Program in Providence, Rhode Island. Licensed in Rhode Island. Registered with an NPI since 2024.

Licensed in
RI
In the registry since
2024
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Providence, RI

No coordinates on file. Search this address in Google Maps

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence LP06198 (RI)

Record details

NPI number1124875059
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 30, 2024
Last updated in NPPESApril 30, 2024
Certification dateApril 30, 2024

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