Individual provider Active NPI

Bonnie Elise Gregg, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1346860061
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2020015213 Issued in MO
Practice address
621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261
Phone
(314) 251-6440
NPI assigned
Apr 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Nurse Practitioner 363LF0000X 2020015213 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261

Mailing address

621 S New Ballas Rd Ste 560a
Saint Louis, MO 63141-8261
Phone (314) 251-6440

Other practice location 1

SIUE School of Nursing Alumni Hall, Room 2117
Edwardsville, IL 62026
Phone (618) 650-3956

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
I20201008002891 MO Practitioner - Nurse Practitioner 4981024106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Trauma and General Surgery LLCGroup PAC ID 1658320700, 44 clinicians

Practice addresses (Care Compare)

621 S New Ballas Rd
Suite 560a
Saint Louis, MO 63141-8261
Phone (314) 569-6440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Trauma and General Surgery, LLC CurrentSince Oct 19, 2020 Accepting new patients
Mercy Clinic Burn and Plastic Surgery, LLC CurrentSince Jan 14, 2024 Accepting new patients

Locations

621 S New Ballas Rd
Ste 560A
Saint Louis, MO 63141
Phone (314) 251-6440

701 S New Ballas Rd
Ste 310
Saint Louis, MO 63141
Phone (314) 251-8750

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1346860061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 560A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418261",
            "telephone_number": "314-251-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 560A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418261",
            "telephone_number": "314-251-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "SIUE School of Nursing Alumni Hall, Room 2117",
            "address_purpose": "LOCATION",
            "city": "Edwardsville",
            "state": "IL",
            "postal_code": "62026",
            "country_code": "US",
            "telephone_number": "618-650-3956",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREGG",
        "first_name": "BONNIE",
        "middle_name": "ELISE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020015213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.