Healthcare Provider Details

I. General information

NPI: 1760649800
Provider Name (Legal Business Name): AMANDA CHERIE BOONE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA SCHAEFER M.D.

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-1328
  • Fax:
Mailing address:
  • Phone: 314-525-1328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036162907
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number53360
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number53360
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2015025548
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: