NPIMap

Organization Active NPI

Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1043574940
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY CLINIC EAST COMMUNITIES
Practice address
615 S New Ballas Rd
Administration Building, 5TH Floor
Saint Louis, MO 63141-8221
Phone
(314) 251-6000
NPI assigned
Jun 26, 2012
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH EAST COMMUNITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Kerry Dunger
Title
Executive Director - Finance
Phone
(314) 364-3707

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X
Emergency Medicine Physician 207P00000X
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
Nurse Practitioner 363L00000X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X
Women's Health Nurse Practitioner 363LW0102X
Family Health Clinical Nurse Specialist 364SF0001X

Addresses

Primary practice location

615 S New Ballas Rd
Administration Building, 5TH Floor
Saint Louis, MO 63141-8221

Mailing address

615 S New Ballas Rd
Administration Building, 5TH Floor
Saint Louis, MO 63141-8221
Phone (314) 251-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070521000006 MO Part B Supplier - Clinic/Group Practice 7214827922 Receives reassigned benefits from 780 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20070521000058 MO Part B Supplier - Clinic/Group Practice 7214827922 Receives reassigned benefits from 211 practitioners
7 other NPIs on this enrollment
Practice locations: Washington, MO; Warrenton, MO; Union, MO; Troy, MO; Sullivan, MO; Saint Clair, MO; Pacific, MO; New Haven, MO…

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

200 State Highway 47
Marthasville, MO 63357
Phone (636) 266-7365

9513 Highway 100
New Haven, MO 63068
Phone (573) 237-6100

440 Hometown Plaza Dr
Owensville, MO 65066
Phone (573) 437-6100

Practitioners & affiliated clinicians

Practitioners 271

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 271

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1043574940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "ADMINISTRATION BUILDING, 5TH FLOOR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "address_2": "ADMINISTRATION BUILDING, 5TH FLOOR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC EAST COMMUNITIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH EAST COMMUNITIES",
        "enumeration_date": "2012-06-26",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "DUNGER",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR - FINANCE",
        "authorized_official_telephone_number": "314-364-3707"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.