Bonnie Lisa Stark, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2012003616 Issued in MO

Practice address

101 S Main St
Rogersville, MO 65742-9357

Phone

(417) 753-9404

Fax

(417) 753-9137

NPI assigned

Feb 8, 2012

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bstark@ochhospital.hin.us

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.

• Sgoh Acquisition Inc

  • Clinic/Center
  • Springfield, MO
  • NPI 1114924768

  MO

  Medicare reassignment
• Primrose Nephrology, Inc.

  • Specialist
  • Springfield, MO
  • NPI 1225163116
  NPD
• Sharlin Health and Neurology, LLC

  • Multi-Specialty Clinic/Center
  • Ozark, MO
  • NPI 1003283532
  NPD (past)

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1669744504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MAIN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429357",
            "telephone_number": "417-753-9404",
            "fax_number": "417-753-9137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "BONNIE",
        "middle_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2012003616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BSTARK@OCHHOSPITAL.HIN.US",
            "affiliation": "N",
            "address_1": "101 S Main St",
            "city": "Rogersville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "657429357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smith Management Services, LLC
• Melanie R. Smith, FNP
• Soundlife Hearing Technologies, LLC.
• Lindsay Sparks, R.D., L.D.
• Jessica Dawn Standeford, M.D.
• Kalli Svoboda, PHARM.D.
• Synergy Recovery Center
• The Healing Place
• Timothy Thompson, PHARM.D.
• Russell Thurman, PTA

• Family Nurse Practitioner in Rogersville, MO
• Providers in Rogersville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.