Jenna Bosarge, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

212 W 3Rd St SW
Rome, GA 30165-2802

Phone

(706) 295-4242

Fax

(706) 295-4260

NPI assigned

Aug 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1497473698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 S WALL ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013062",
            "telephone_number": "706-624-3000",
            "fax_number": "706-624-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 3RD ST SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652802",
            "telephone_number": "706-295-4242",
            "fax_number": "706-295-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSARGE",
        "first_name": "JENNA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "SLP012243",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "syork@advanceforkids.org",
            "affiliation": "N",
            "address_1": "212 W 3rd St SW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301652802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Morgan Boatner, PHARM.D.
• Marius Florin Bodiu, DPT
• Michael Ann Booth, PA
• Marc Borchardt, CRNA
• Joseph John Borrillo, PA
• Mark Ricard Boudreau Jr., DO
• Boundless Therapy Services, LLC
• Amine Bourbia, MD
• Alan Lee Bowen, MD
• David Bowen, DDS

• Speech-Language Pathologist in Rome, GA
• Providers in Rome, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.