MEDICARE: BLOOM PEDIATRICS WALK IN CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner

General Provider Information

NPI Number	:	1124991443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLOOM PEDIATRICS WALK IN CLINIC LLC

Provider Business Mailing Address
First Line	:	5529 ARDEN MILL DR STE 101
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-6977
Country	:	US
Telephone Number	:	808-721-0179
Fax Number	:

Provider Business Practice Location Address
First Line	:	5529 ARDEN MILL DR STE 101
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29715-6977
Country	:	US
Telephone Number	:	808-721-0179
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER/OWNER
Name	:	ASHLENE KARASCH
Credential	:	NP
Telephone Number	:	808-721-0179

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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