Individual provider Active NPI

Charles F Carey, M.D.

  • Cardiovascular Disease Physician
  • Saint Louis, MO
National Provider Identifier
1104822014
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
105346 Issued in MO
Practice address
10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128-2197
Phone
(314) 842-0602
Fax
(314) 842-4372
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 105346 MO Primary

Addresses

Primary practice location

10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128-2197

Mailing address

10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197
Phone (314) 842-0602

Other identifiers 2

IdentifierTypeStateIssuer
208679712MedicaidMO
208679720MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031107000067 MO Practitioner - Cardiovascular Disease (Cardiology) 2163335084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Missouri, Kansas City, School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

10012 Kennerly Rd
Suite 300
Saint Louis, MO 63128-2197
Phone (314) 842-0602

Hospital & facility affiliations

  • Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
  • Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
  • Mercy Hospital Jefferson Hospital, Crystal City, MO, CCN 260023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
105346MOMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Heart and Vascular, LLC Cardiovascular Disease CurrentSince Jan 1, 2020 Accepting new patients
Metro Heart Group of St. Louis, Inc. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients
Mercy Hospital South Past Accepting new patients

Locations

1390 US Highway 61
Ste 3300
Crystal Cty, MO 63028
Phone (636) 931-6303

1001 S Kirkwood Rd
Ste 310
Saint Louis, MO 63122
Phone (314) 692-2807

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

10012 Kennerly Rd
Ste 202
Saint Louis, MO 63128
Phone (314) 692-2807

4280 Mid America Ln
Ste 10
Saint Louis, MO 63129
Phone (314) 692-2807

7345 Watson Rd
Ste LL1
Saint Louis, MO 63119
Phone (314) 525-1300

625 S New Ballas Rd
Ste 2015
Saint Louis, MO 63141
Phone (314) 251-1775

10012 Kennerly Rd
Ste 300
Saint Louis, MO 63128
Phone (314) 842-0602

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

Interoperability endpoints

  • Direct secure messaging: ccarey99975@directc.mercy.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mercy Hospital SouthSaint Louis, MO, CCN 260077 Hospital Corporate Director Jul 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1104822014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "SUITE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-842-0602",
            "fax_number": "314-842-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD",
            "address_2": "STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-842-0602",
            "fax_number": "314-842-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAREY",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "105346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208679712",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208679720",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.