Organization Active NPI

Mercy Clinic Children's Heart Center, LLC

  • Pediatric Cardiology Physician
  • Saint Louis, MO
National Provider Identifier
1144399338
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
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, 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 25, 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
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

IdentifierTypeStateIssuer
500211800MedicaidMO

Other names 1

  • Mercy Childrens Heart Center, 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
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.

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.

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

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.

Verify at the official NPI Registry.