Active NPI
Mercy Clinic Children's Heart Center, LLC
- Pediatric Cardiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- Legal business name
- MERCY CLINIC CHILDREN'S HEART CENTER, LLC
- Practice address
- 621 S New Ballas Road
Suite 198-a
St Louis, MO 63141-8255 - Phone
- (314) 251-6777
- Fax
- (314) 251-5859
- NPI assigned
- Nov 6, 2006
- Last updated
- Apr 25, 2025
- Organization subpart
- Yes
- Parent organization
- MERCY CLINIC EAST COMMUNITIES
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | Primary |
Addresses
Primary practice location
621 S New Ballas Road
Suite 198-a
St Louis, MO 63141-8255
Mailing address
621 S New Ballas Road
Suite 198-a
St Louis, MO 63141-8255
Phone (314) 251-6777
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500211800 | Medicaid | MO |
Other names 1
- Mercy Childrens Heart Center, LLC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051102000879 | MO | Part B Supplier - Clinic/Group Practice | 1456379080 | Practice locations: Saint Louis, MO |
National Provider Directory
National Provider Directory- Part of
- Gregory P Genova MD
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
120 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6021
621 S New Ballas Rd
Ste 195A
Saint Louis, MO 63141
Phone (314) 251-1440
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.
-
- Endocrinology, Diabetes & Metabolism Physician
- Ballwin, MO
- NPI 1700370061
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Cardiovascular Disease Physician
- Saint Louis, MO
- NPI 1902882202
-
- Pediatric Nurse Practitioner
- Saint Louis, MO
- NPI 1497980387
-
- Internal Medicine Physician
- Portland, OR
- NPI 1295072866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745539200000",
"number": "1144399338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS ROAD",
"address_2": "SUITE 198-A",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "631418255",
"telephone_number": "314-251-6777",
"fax_number": "314-251-5859"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS ROAD",
"address_2": "SUITE 198-A",
"city": "ST LOUIS",
"state": "MO",
"postal_code": "631418255",
"telephone_number": "314-251-6777",
"fax_number": "314-251-5859"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCY CLINIC CHILDREN'S HEART CENTER, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
"enumeration_date": "2006-11-06",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"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": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500211800",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mercy Childrens Heart Center, LLC",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Mercy Childrens Heart Center, LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Saint Louis, MO
- Mercy Clinic Burn and Plastic Surgery, LLC
- Mercy Clinic Cardiovascular and Thoracic Surgery, LLC
- Mercy Clinic Child and Adolescent Psychiatry, LLC
- Mercy Clinic Child Neurology, LLC
- Mercy Clinic Children's Critical Care, LLC
- Mercy Clinic Children's Hospitalists - St. Louis, LLC
- Mercy Clinic Children's Infectious Disease, LLC
- Mercy Clinic Children's Palliative Care LLC
- Mercy Clinic Children's Respiratory and Sleep Medicine, LLC
- Mercy Clinic Children's Surgery, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.