Individual provider Active NPI

Robert Francis Westerheide II, ACNP

  • Acute Care Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1699723478
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2001019040 Issued in MO
Practice address
12700 Southfork Rd
Saint Louis, MO 63128-3201
Phone
(314) 895-6565
Fax
(314) 892-4828
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2001019040 MO Primary

Addresses

Primary practice location

12700 Southfork Rd
Saint Louis, MO 63128-3201

Mailing address

12700 Southfork Rd
Saint Louis, MO 63128-3201
Phone (314) 895-6565

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
I20060530000073 MO Practitioner - Nurse Practitioner 0648281923 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Impact Physician Group Missouri Cardiology Services LLCGroup PAC ID 0042671000, 2 clinicians

Practice addresses (Care Compare)

12380 De Paul Dr
Bridgeton, MO 63044-2511
Phone (314) 447-9700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2001019040MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Physician Group, Missouri Cardiology Services LLC CurrentSince Nov 14, 2024 Accepting new patients
Intermed Medical Consultants Inc Current Accepting new patients
Impact Physician Group, Missouri Pulmonary Services LLC CurrentSince Feb 17, 2023 Accepting new patients
Impact Physician Group, Missouri, LLC CurrentSince Sep 13, 2024 Accepting new patients

Locations

12380 De Paul Dr
Bridgeton, MO 63044
Phone (314) 447-9700

500 NW 68th St
Kansas City, MO 64118
Phone (816) 420-3600

4850 Lemay Ferry Rd
Ste 210
Saint Louis, MO 63129
Phone (314) 892-6565

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1699723478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-895-6565",
            "fax_number": "314-892-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12700 SOUTHFORK RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631283201",
            "telephone_number": "314-895-6565",
            "fax_number": "314-892-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERHEIDE",
        "first_name": "ROBERT",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2001019040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.