Individual provider Active NPI

Robert David Bohnert, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1174293559
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021037378 Issued in MO
Practice address
10012 Kennerly Rd Ste 102
Saint Louis, MO 63128-2197
Phone
(314) 543-5911
NPI assigned
Sep 16, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021037378 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd Ste 102
Saint Louis, MO 63128-2197

Mailing address

1300 Shirley LN
Festus, MO 63028-4328
Phone (636) 524-2328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228001105 MO Practitioner - Nurse Practitioner 3870984958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Mississippi School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Gastroenterology LLCGroup PAC ID 8628121795, 66 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 102
Saint Louis, MO 63128-2197
Phone (314) 543-5911

Hospital & facility affiliations

  • Ste Genevieve County Memorial Hospital Hospital, Sainte Genevieve, MO, CCN 261330
  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ste Genevieve County Memorial Hospital CurrentSince Dec 1, 2021 Accepting new patients
Ste Genevieve County Memorial Hospital Current Accepting new patients
Mercy Clinic Gastroenterology, LLC CurrentSince Jan 27, 2025 Accepting new patients
Ste Genevieve County Memorial Hospital CurrentSince Dec 1, 2021 Accepting new patients

Locations

255 Boderman
Bloomsdale, MO 63627
Phone (573) 483-2727

200 Brevco Plz
Ste 208
Lake St Louis, MO 63367
Phone (314) 251-3880

10012 Kennerly Rd
Ste 102
Saint Louis, MO 63128
Phone (314) 525-4225

590 Pine Dr
Ste Genevieve, MO 63670
Phone (573) 883-4455

120 Plaza Dr
Ste Genevieve, MO 63670
Phone (573) 883-1199

753 Pointe Basse Dr
Ste Genevieve, MO 63670
Phone (573) 883-2782

800 Ste Genevieve Dr
Ste Genevieve, MO 63670
Phone (573) 883-2571

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1174293559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SHIRLEY LN",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630284328",
            "telephone_number": "636-524-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 102",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-543-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNERT",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021037378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.