Individual provider Active NPI

Samantha Bunch, APRN FNP-BC

  • Primary Care Nurse Practitioner
  • Saint Peters, MO
National Provider Identifier
1679247019
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
2021022692 Issued in MO
Practice address
5200 Executive Centre Pkwy Ste 300
Saint Peters, MO 63376-3394
Phone
(636) 229-4222
NPI assigned
Aug 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 2021022692 MO Primary

Addresses

Primary practice location

5200 Executive Centre Pkwy Ste 300
Saint Peters, MO 63376-3394

Mailing address

5200 Executive Centre Pkwy Ste 300
Saint Peters, MO 63376-3394
Phone (636) 229-4222

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
I20220510001057 MO Practitioner - Nurse Practitioner 4183001332 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Peters Bone and Joint Surgery Inc 26 clinicians

Practice addresses (Care Compare)

378 Shadow Pines Dr
Wentzville, MO 63385-3745
Phone (636) 441-3444

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Merit-based Incentive Payment System (MIPS)

Final score
94.79 of 100Reported as group
Quality
96.04
Improvement activities
40
Cost
89.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Peters Bone & Joint Surgery Inc. CurrentSince Sep 12, 2022 Accepting new patients
Barnes Health Care Management Group LLC CurrentSince May 9, 2022 Accepting new patients
St Peters Bone & Joint Surgery Inc. CurrentSince Sep 12, 2022 Accepting new patients

Locations

2101 Corona Rd
Ste 102
Columbia, MO 65203
Phone (573) 234-1800

1734 Market St
Hannibal, MO 63401
Phone (573) 221-2930

1333 Scenic Dr
Herculaneum, MO 63048
Phone (636) 931-2995

11515 Troost Ave
Kansas City, MO 64131
Phone (813) 943-4104

2041 Silva Ln
Moberly, MO 65270
Phone (660) 263-1894

4701 Highway K
O Fallon, MO 63368
Phone (636) 441-3444

4401 N Hanley Rd
Saint Louis, MO 63134
Phone (314) 521-7471

5200 Executive Centre Pkwy
Ste 300
Saint Peters, MO 63376
Phone (636) 229-4222

2800 Highway TT
#Four
Sedalia, MO 65301
Phone (660) 826-8803

378 Shadow Pines Dr
Wentzville, MO 63385
Phone (636) 441-3444

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73033

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1679247019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 EXECUTIVE CENTRE PKWY STE 300",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763394",
            "telephone_number": "636-229-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 EXECUTIVE CENTRE PKWY STE 300",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633763394",
            "telephone_number": "636-229-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNCH",
        "first_name": "SAMANTHA",
        "credential": "APRN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MO",
            "license": "2021022692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.