NPIMap

Organization Active NPI

Saint Lukes East Hospital

Doing business as Saint Luke's East Lee's Summit Hospital

  • General Acute Care Hospital
  • Lee's Summit, MO
National Provider Identifier
1053353490
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
495-0 Issued in MO
Legal business name
SAINT LUKES EAST HOSPITAL
Doing business as
Saint Luke's East Lee's Summit Hospital
Practice address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Phone
(816) 347-5000
NPI assigned
Jun 11, 2006
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Matthew Marino
Title
Cfo
Phone
(816) 347-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 495-0 MO Primary

Addresses

Primary practice location

100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000

Mailing address

PO Box 504197
Saint Louis, MO 63150-0001
Phone (816) 932-5450

Other identifiers 4

IdentifierTypeStateIssuer
016245607MedicaidMO
60329OtherHEALTHCARE USA
200370980AMedicaidKS
925714OtherKSKS FIRST GUARD MC

Other names 1

  • Saint Luke's East Lee's Summit Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4 Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051219000745 MO Part A Provider - Hospital 9234151259 Practice locations: Lees Summit, MO; Blue Springs, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053353490. Details of each certification follow.

Hospital certification: CCN 260216

Legal name
SAINT LUKES EAST HOSPITAL
Doing business as
BJC HEALTHCARE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 3, 2006
Last certification
May 7, 2014
Beds
240
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
100 NE Saint Lukes Blvd
Lees Summit, MO 64086-6000
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Saint Luke's East HospitalCCN 260216 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert L Olm-Shipman Individual Corporate OfficerCeo Mar 28, 2019
Corporate DirectorBoard Member Mar 28, 2019
W-2 Managing EmployeeCeo Mar 28, 2019
Jake Loveless Individual Corporate DirectorBoard Member Jan 1, 2020
Christine Bushyhead Individual Corporate DirectorBoard Member Mar 1, 2023
Brenden Ellis Individual Corporate DirectorBoard Member Jan 1, 2024
Jose H Lopez Individual Corporate DirectorBoard Member Jan 1, 2024
Ryan Crider Individual Corporate DirectorBoard Member Jan 1, 2025
Jessica Blubaugh Individual Corporate DirectorBoard Member Jan 1, 2025
Saint Lukes Health System Inc Organization, Kansas City, MO Non-profit 5% Or Greater Direct Ownership Interest Jan 30, 2006 100%
Wesley Moxley Individual Corporate DirectorBoard Member Jan 1, 2018
Veronica Ford Individual Corporate DirectorBoard Member Jan 1, 2025
Amy M Nachtigal Individual Corporate DirectorVice President, Finance Jul 4, 2025
Operational/Managerial ControlVice President Jul 4, 2025
BJC Health System Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Larry Frederick Frevert Individual Corporate DirectorBoard Member Jan 1, 2018
Julie Quirin Individual Corporate OfficerSLHS President Jan 1, 2024
Daniel Frank Rexroth Individual Corporate DirectorBoard Member Sep 1, 2015
Robert L Ellerman Individual Corporate DirectorBoard Member Mar 1, 2023
Keith Asel Individual Corporate DirectorBoard Member Jan 1, 2020
David Aubuchon Individual Corporate DirectorBoard Member Jan 1, 2024
Marylynne Lucido Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners & affiliated clinicians

Practitioners 74

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 74

Affiliated clinicians 1,006

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,006

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1053353490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504197",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631500001",
            "telephone_number": "816-932-5450",
            "fax_number": "816-932-1694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE SAINT LUKES BLVD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640866000",
            "telephone_number": "816-347-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUKES EAST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "816-347-5000"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MO",
            "license": "495-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016245607",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE USA",
            "identifier": "60329",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200370980A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS FIRST GUARD MC",
            "identifier": "925714",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 NE Saint Lukes Blvd",
            "city": "Lees Summit",
            "state": "MO",
            "country_code": "US",
            "postal_code": "640866000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Saint Luke's East Lee's Summit Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Saint Luke's East Lee's Summit Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.