Jessica Bohm

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

4455 24TH Ave Ste 150
Fort Gratiot, MI 48059-4516

Phone

(248) 232-0905

NPI assigned

May 15, 2025

Last updated

May 15, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1801687074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3453 SAINT CLAIR SHORES BLVD",
            "city": "EAST CHINA",
            "state": "MI",
            "postal_code": "480541578",
            "telephone_number": "810-990-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 24TH AVE STE 150",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594516",
            "telephone_number": "248-232-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHM",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Serenity Counseling PLLC
• Blue Water Sleep Inc
• Blue Water Urgent Care PLLC
• Blue Water Voice LLC
• Karlene Bognar
• Emma Bonner
• Christopher J Borgiel, M.D.
• Savannah Leigh Borgman
• Carolyn Margaret Bourgois, MA/CNA/
• Janeen Bourlier

• Speech-Language Pathologist in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.