Blue Water Sleep Inc

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

BLUE WATER SLEEP INC

Practice address

5316 Lakeshore Rd
Fort Gratiot, MI 48059-3118

Phone

(810) 357-8792

NPI assigned

Aug 28, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica Heaney, NP

Title

Manager

Phone

(586) 524-5801

Specialties & licenses 13

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699747200000",
    "number": "1174308290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5316 LAKESHORE RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593118",
            "telephone_number": "810-357-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5316 LAKESHORE RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593118",
            "telephone_number": "810-357-8792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER SLEEP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-11-12",
        "certification_date": "2023-11-11",
        "status": "A",
        "authorized_official_last_name": "HEANEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-524-5801",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Mental Health Clinic
• Blue Water Mental Health Clinic
• Blue Water Nursing Center
• Blue Water Primary Care
• Blue Water Serenity Counseling PLLC
• Blue Water Urgent Care PLLC
• Blue Water Voice LLC
• Karlene Bognar
• Jessica Bohm
• Emma Bonner

• Home Health Registered Nurse in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Home Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.