Amy R Bohm, PNP

Key facts

NPI

1326426560

Entity type

Individual (NPI type 1)

Primary specialty

Pediatric Nurse Practitioner 363LP0200X

License

2016033617 (MO)

Practice address

1520 Wentzville Pkwy
Wentzville, MO 63385-3408

Phone

(636) 497-4055

NPI assigned

May 8, 2015

Sex

Female

Sole proprietor

No

Organizations & group practices 8

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.

• Cardiothoracic Surgery, LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Chesterfield, MO · NPI 1104895812
  Medicare reassignment Care Compare group NPD MO
• Physician Groups LC Multi-Specialty Clinic/Center · Saint Louis, MO · NPI 1285664268
  Medicare reassignment Care Compare group NPD MO
• Washington University Multi-Specialty Clinic/Center · Saint Louis, MO · NPI 1194765685
  Medicare reassignment NPD MO
• Washington University Physicians in Illinois, Inc Multi-Specialty Clinic/Center · O Fallon, IL · NPI 1477076263
  Medicare reassignment NPD IL
• Physician Groups LC Multi-Specialty Clinic/Center · Farmington, MO · NPI 1427114990
  NPD
• Washington University Multi-Specialty Clinic/Center · Saint Louis, MO · NPI 1962442475
  NPD
• Washington University Physicians in Illinois, Inc Multi-Specialty Clinic/Center · Saint Louis, MO · NPI 1457203135
  NPD
• Washington University Physicians in Illinois, Inc. Multi-Specialty Clinic/Center · O Fallon, IL · NPI 1528569845
  NPD

Hospital & facility affiliations 2

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

• Progress West Healthcare Center General Acute Care Hospital · O Fallon, MO · NPI 1508938044
  Care Compare affiliation Hospital
• St. Lukes Episcopal-Presbyterian Hospital General Acute Care Hospital · Chesterfield, MO · NPI 1346251543
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Saint Louis University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LC (526 clinicians)
Cardiothoracic Surgery, LLC (14 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Hospital Hospital · Chesterfield, MO · CCN 260179
• Progress West Hospital Hospital · Ofallon, MO · CCN 260219

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in MO, IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

Electronic endpoints

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 25, 2025.

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1326426560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-2341",
            "fax_number": "314-454-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853408",
            "telephone_number": "636-497-4055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Emergency Med",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101002",
            "country_code": "US",
            "telephone_number": "314-454-2341",
            "fax_number": "314-454-4345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHM",
        "first_name": "AMY",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "2016033617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420039759",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Emergency Med",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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All providers in Wentzville, MO · Pediatric Nurse Practitioner in Missouri