NPIMap

Organization Active NPI

Mercy Clinic Children's Urology LLC

  • Pediatric Urology Physician
  • Saint Louis, MO
National Provider Identifier
1154612166
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
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
Last updated
Apr 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 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 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 IDStateProvider typePAC IDDetails
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
Unity Medical Group Wes

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, 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": "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": "",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "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 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.

Verify at the official NPI Registry.