NPIMap

Organization Active NPI

Mercy Clinic Neurology, LLC

  • Neurology Physician
  • Saint Louis, MO
National Provider Identifier
1053479188
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MERCY CLINIC NEUROLOGY, LLC
Practice address
621 S New Ballas Rd
Suite 6005-B
Saint Louis, MO 63141-8232
Phone
(314) 251-6075
Fax
(314) 251-6634
NPI assigned
Dec 4, 2006
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY CLINIC EAST COMMUNITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 6005-B
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Suite 6005-B
Saint Louis, MO 63141-8232
Phone (314) 251-6075

Other identifiers 2

IdentifierTypeStateIssuer
DO0017OtherMORAILROAD MEDICARE
1053479188MedicaidMO

Other names 1

  • Mercy Neurology, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070418000103 MO Part B Supplier - Clinic/Group Practice 8729183967 Receives reassigned benefits from 24 practitioners
Practice locations: Chesterfield, MO; Festus, MO; Ofallon, MO; Saint Louis, MO

National Provider Directory

National Provider Directory
Part of
Mercy Clinic Communities

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1400 US Highway 61
Ste 120
Crystal Cty, MO 63028
Phone (636) 933-8050

2223 Technology Dr
Ste 4
O Fallon, MO 63368
Phone (314) 227-2020

12700 Southfork Rd
Ste 270
Saint Louis, MO 63128
Phone (314) 525-4520

621 S New Ballas Rd
Ste 281A
Saint Louis, MO 63141
Phone (314) 251-4772

621 S New Ballas Rd
Ste 5003B
Saint Louis, MO 63141
Phone (314) 227-2020

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1053479188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 6005-B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6075",
            "fax_number": "314-251-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 6005-B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6075",
            "fax_number": "314-251-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC NEUROLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "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": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DO0017",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053479188",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Neurology, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 28, 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.