ELIZABETH BOKERMANN (NPI# 1679968135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679968135 |
| Entity Type | Individual |
| Full Name | ELIZABETH BOKERMANN |
| Credential | PA |
| Practice Address |
12266 Depaul Dr Suite 220 Bridgeton MO 63044 |
| Mailing Address |
1551 Wall St Suite 310 Saint Charles MO 63303-3539 |
| Practice Telephone | 3142917900 |
| Mailing Telephone | 6366692268 |
| Mailing Fax Number | 3142098127 |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2015-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2015008953 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | LICENSE | 2015008953 | 01 |
| Street Address |
12266 DEPAUL DR SUITE 220 |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023034857 | Crystel D Knierim | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| 1174897862 | Neurological Diagnostics, LLC | Psychiatry & Neurology | 12266 Depaul Dr, Suite 130, Bridgeton, MO 63044-2514 | 2012-02-28 |
| 1871730499 | Janet R Knebel | Registered Nurse | 12266 Depaul Dr, Suite 305, Bridgeton, MO 63044-2514 | 2009-01-20 |
| 1427212471 | Orthotic and Prosthetic Lab, Inc. | Durable Medical Equipment & Medical Supplies | 12266 Depaul Dr, Suite 120, Bridgeton, MO 63044-2514 | 2008-07-17 |
| 1801958343 | Signature Health Services Inc | Obstetrics & Gynecology | 12266 Depaul Dr, Suite 200, Bridgeton, MO 63044 | 2006-12-14 |
| 1871696203 | Thomas Michael Gotsis | Dentist | 12266 Depaul Dr, Ste 325, Bridgeton, MO 63044 | 2006-09-07 |
| 1235245598 | Joshua Stuart Glaser | Surgery | 12266 Depaul Dr, Suite 305, Bridgeton, MO 63044-2516 | 2006-08-21 |
| 1255357091 | Randall D Roush | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| 1154347995 | Terry J Weis | Orthopaedic Surgery | 12266 Depaul Dr, 110, Bridgeton, MO 63044-2514 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396796041 | Paul J Diesfeld | Physician Assistant | 12349 De Paul Dr Ste 100, Bridgeton, MO 63044-2512 | 2006-05-15 |
| 1538160015 | Stacey L Smick | Physician Assistant | 70 Cornwell Dr, Bridgeton, NJ 08302-3602 | 2005-08-09 |
| 1255965422 | Kayla Michele Richter | Physician Assistant | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2020-02-26 |
| 1013548767 | Blessing Kudakwashe Tupiri | Physician Assistant | 12266 De Paul Dr Ste 205, Bridgeton, MO 63044-2514 | 2020-01-31 |
| 1942714464 | Kelly A Hoffman | Physician Assistant | 133 Polk Ln, Bridgeton, NJ 08302-5905 | 2017-11-20 |
| 1437590437 | Courtney C Grodie | Physician Assistant | 12349 De Paul Dr, Bridgeton, MO 63044-2512 | 2013-07-08 |
| 1053660076 | Bridgeton Emergency Group LLC | Physician Assistant | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2012-09-05 |
| 1154639318 | Jennifer Cafi | Physician Assistant | 12303 De Paul Dr, Bridgeton, MO 63044-2512 | 2010-09-21 |
| 1275706913 | Amber Renee Johnson | Physician Assistant | 12255 De Paul Dr, Suite 460, Bridgeton, MO 63044-2510 | 2008-04-02 |
| 1356393961 | Lynn M Robbins | Physician Assistant | 12349 De Paul Dr Ste 100, Bridgeton, MO 63044-2512 | 2006-05-16 |
| Find all providers in BRIDGETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.