Active NPI
Mercy Clinic Children'S Urology LLC
- Pediatric Urology Physician
- Saint Louis, MO
National Provider Identifier
1154612166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Urology Physician
- Legal business name
- MERCY CLINIC CHILDREN'S UROLOGY LLC
- Practice address
- 621 S New Ballas Rd
Suite 537-a
Saint Louis, MO 63141-8232 - Phone
- (314) 251-6990
- Fax
- (314) 251-6998
- NPI assigned
- Apr 25, 2011
- Organization subpart
- Yes
- Parent organization
- MERCY MEDICAL GROUP
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 Urology Physician | 2088P0231X | Primary |
Addresses
Primary practice location
621 S New Ballas Rd
Suite 537-a
Saint Louis, MO 63141-8232
Mailing address
621 S New Ballas Rd
Suite 537-a
Saint Louis, MO 63141-8232
Phone (314) 251-6990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121116000537 | MO | Part B Supplier - Clinic/Group Practice | 1355592569 |
Receives reassigned benefits from 4 practitioners Practice locations: Saint Louis, MO |
National Provider Directory
National Provider Directory- Part of
- St John'S Mercy Medical Group
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
621 S New Ballas Rd
Ste 621A
Saint Louis, MO 63141
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303689600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745798400000",
"number": "1154612166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD",
"address_2": "SUITE 537-A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418232",
"telephone_number": "314-251-6990",
"fax_number": "314-251-6998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD",
"address_2": "SUITE 537-A",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418232",
"telephone_number": "314-251-6990",
"fax_number": "314-251-6998"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERCY CLINIC CHILDREN'S UROLOGY LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MERCY MEDICAL GROUP",
"enumeration_date": "2011-04-25",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"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": "2088P0231X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology, Pediatric Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
- 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
- Mercy Clinic East Communities
- Mercy Clinic East Communities
- Mercy Clinic East Communities
- Mercy Clinic East Communities
- Mercy Clinic East Community
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.