Organization Active NPI

Mercy Aco Provider Services LLC

  • General Acute Care Hospital
  • Saint Louis, MO
National Provider Identifier
1053759704
Registry record updated Jan 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MERCY ACO PROVIDER SERVICES LLC
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(314) 251-1376
NPI assigned
Jun 4, 2013
Organization subpart
Yes
Parent organization
MERCY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2014

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

Authorized official

Name
Mr. Shannon Sock
Title
President Mercy Aco
Phone
(314) 251-6000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Clinical Cardiac Electrophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0001X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

625 S New Ballas Rd
Suite 7020
Saint Louis, MO 63141-8253
Phone (314) 251-1376

National Provider Directory

National Provider Directory

Locations

625 S New Ballas Rd
Ste 7020
Saint Louis, MO 63141
Phone (314) 251-6486

Interoperability endpoints

  • FHIR API: https://carepath.health-partners.org/Proxy-FHIR/MYCHART/api/FHIR/R4
  • FHIR API: https://epic-fhir.mercy.net/prdfhirstl/api/FHIR/R4/

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389139200000",
    "number": "1053759704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S NEW BALLAS RD",
            "address_2": "SUITE 7020",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418253",
            "telephone_number": "314-251-1376",
            "fax_number": "314-251-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "314-251-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY ACO PROVIDER SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH",
        "enumeration_date": "2013-06-04",
        "last_updated": "2014-01-08",
        "status": "A",
        "authorized_official_last_name": "SOCK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT MERCY ACO",
        "authorized_official_telephone_number": "314-251-6000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.