Individual provider Active NPI

Bo M Bohlmann, PHD

  • Clinical Psychologist
  • Medina, OH
National Provider Identifier
1386996288
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3781 Issued in OH
Practice address
3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Phone
(330) 764-7916
Fax
(330) 723-6399
NPI assigned
Oct 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3781 OH Primary

Addresses

Primary practice location

3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334

Mailing address

3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334
Phone (330) 764-7916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3781OHMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Consultants Inc Clinical PastSince Nov 7, 1997 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/psychologyconsultantsinc/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1386996288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHLMANN",
        "first_name": "BO",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.