Bonnie E Johnston, ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2012016906 Issued in MO

Practice address

11700 Studt Ave
Saint Louis, MO 63141-7031

Phone

(314) 989-1181

Fax

(314) 989-1441

NPI assigned

Oct 26, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Hyperbaric and Wound Care LLCGroup PAC ID 0345468526, 15 clinicians

Mercy Clinic Burn and Plastic Surgery LLCGroup PAC ID 4688622822, 14 clinicians

Mercy Clinic Trauma and General Surgery LLCGroup PAC ID 1658320700, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Mercy Clinic Hyperbaric and Wound Care LLC

  • Surgery Physician
  • Festus, MO
  • NPI 1336568864
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Trauma and General Surgery, LLC

  • Trauma Surgery Physician
  • Saint Louis, MO
  • NPI 1699825695
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Burn and Plastic Surgery, LLC

  • Plastic and Reconstructive Surgery Physician
  • St. Louis, MO
  • NPI 1912037433
  Medicare reassignment Care Compare group

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

• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1487106399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 STUDT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417031",
            "telephone_number": "314-989-1181",
            "fax_number": "314-989-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11700 STUDT AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417031",
            "telephone_number": "314-989-1181",
            "fax_number": "314-989-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "BONNIE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012016906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487106399",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wynter Annette Johnson, CNA
• Zach Johnson
• Johnson'S Phenomenal Hands LLC
• Johnsons Phenomenal Hands LLC
• Andrea Jo Johnston
• Jessica Lauren Johnston, NP-C
• Kelly L Johnston, MPT
• Lauren Johnston, PHARM.D.
• Logan Matthew Johnston, CRNA
• Marilyn F.M. Johnston, M.D.

• Adult Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.