NPIMap

Individual provider Active NPI

James Lee Bockhorst, MD

  • Internal Medicine Physician
  • Troy, MO
National Provider Identifier
1053306522
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
221366 Issued in MO
Practice address
1177 E Cherry St
Troy, MO 63379-1520
Phone
(636) 528-1919
Fax
(636) 528-1916
NPI assigned
Sep 12, 2005
Last updated
Feb 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 221366 MO Primary
Pediatrics Physician 208000000X 077577 MO

Addresses

Primary practice location

1177 E Cherry St
Troy, MO 63379-1520

Mailing address

176 Gorget Dr
Troy, MO 63379-2538
Phone (636) 528-2321

Other identifiers 1

IdentifierTypeStateIssuer
208774109MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040730000167 MO Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8921078536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Saint Louis University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1165 E Cherry St
Troy, MO 63379-1520
Phone (636) 528-7722

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221366MOMDInternal Medicine Physician
077577MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Lincoln CurrentSince Feb 27, 2017 Accepting new patients
Mercy Hospital Lincoln Internal Medicine CurrentSince Feb 27, 2017 Accepting new patients

Locations

1165 E Cherry St
Troy, MO 63379
Phone (636) 528-1919

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

Networks

  • IA HMO C-SNP
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: jbockhorst698136@directc.mercy.net

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1053306522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 GORGET DR",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633792538",
            "telephone_number": "636-528-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 E CHERRY ST",
            "city": "TROY",
            "state": "MO",
            "postal_code": "633791520",
            "telephone_number": "636-528-1919",
            "fax_number": "636-528-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKHORST",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "221366",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "077577",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208774109",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MO

Sources for this page

Verify at the official NPI Registry.