NPIMap

Organization Active NPI

Mercy Hospital South

  • Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1104974518
Registry record updated Dec 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
150546 Issued in MO
Legal business name
MERCY HOSPITAL SOUTH
Practice address
10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone
(314) 525-4859
NPI assigned
Jan 8, 2007
Last updated
Dec 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2018

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

Authorized official

Name
Cheryl Matejka
Title
Cfo East Communities & Sfo
Phone
(314) 251-1958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 150546 MO Primary

Addresses

Primary practice location

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Mailing address

10010 Kennerly Road
St Louis, MO 63128
Phone (314) 525-4859

National Provider Directory

National Provider Directory
Tax ID family
St Anthonys Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545609600000",
    "number": "1104974518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY ROAD",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63128",
            "telephone_number": "314-525-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-12-24",
        "status": "A",
        "authorized_official_last_name": "MATEJKA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO EAST COMMUNITIES & SFO",
        "authorized_official_telephone_number": "314-251-1958"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "150546",
            "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 Dec 24, 2018; 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.