Carl Bohm, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2021-01331 Issued in NC

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 655-2109

NPI assigned

Apr 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, TN, MO3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Emergency Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital - St Louis Hospital, Saint Louis, MO, CCN 260091

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: cbohm187047@direct-ehr-ssmhc.com

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.

• Cep America, LLC

  • Emergency Medicine Physician
  • Saint Louis, MO
  • NPI 1619332046
  Medicare reassignment Care Compare group NPD
• Murphy Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Murphy, NC
  • NPI 1053808378
  Medicare reassignment NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1396282463
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Richmond Heights, MO
  • NPI 1942855366
  NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Dunlap, TN
  • NPI 1699212761
  NPD
• Tennessee River Physicians, PLLC

  • Emergency Medicine Physician
  • Chattanooga, TN
  • NPI 1710424882
  NPD

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

• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1336387836
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1962572396
  Care Compare affiliation

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1609372952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616374909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHM",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2021-01331",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2024024643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle W Boerke, PSYD
• Tera Boettcher, MSW
• Soujanya Bogarapu, MD
• Bogard Drug No. 5, Inc.
• Carole Katherine Bohlman, PTA
• Andrew Bokus, CRNA
• Allison Boley
• Thomas Joseph Bollaert, MD
• Joshua Bolliger, CRNA
• Ryschell Renee Bolton, D.O.

• Emergency Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.