Individual provider Active NPI

Laura Bo-Khia Niboh, WHNP-BC

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1225827793
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2025016859 Issued in MO
Practice address
1110 Highlands Plaza Drive
#280
Saint Louis, MO 63110-1351
Phone
(314) 286-2620
NPI assigned
May 1, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2016017714 MO
Nurse Practitioner 363L00000X 2025016859 MO Primary

Addresses

Primary practice location

1110 Highlands Plaza Drive
#280
Saint Louis, MO 63110-1351

Mailing address

PO Box 959354 #280
Saint Louis, MO 63195-0001
Phone (314) 286-2620

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 Health Information Exchange (HIE)

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
I20250726000111 MO Practitioner - Nurse Practitioner 8527575471 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

1110 Highlands Plaza Dr E
Saint Louis, MO 63110-1351
Phone (314) 273-0195

2630 Hwy K
O Fallon, MO 63368-6624
Phone (636) 240-5454

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016017714MOMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC CurrentSince Aug 1, 2025 Accepting new patients
Physician Groups LC CurrentSince Aug 1, 2025 Accepting new patients

Locations

2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454

1110 Highlands Plaza Dr E
Ste 280
Saint Louis, MO 63110
Phone (314) 273-0195

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

Organizations & group practices 2

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": "1746057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1225827793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959354 #280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631950001",
            "telephone_number": "314-286-2620",
            "fax_number": "314-286-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 HIGHLANDS PLAZA DRIVE",
            "address_2": "#280",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101351",
            "telephone_number": "314-286-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIBOH",
        "first_name": "LAURA",
        "middle_name": "BO-KHIA",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-01",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2016017714",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2025016859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1110 Highlands Plaza Drive",
            "address_2": "#280",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.