NPIMap

Organization Active NPI

Mercy Support Services

Doing business as Mercy JFK Clinic

  • Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1265572812
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MERCY SUPPORT SERVICES
Doing business as
Mercy JFK Clinic
Practice address
621 S New Ballas Rd
Saint Louis, MO 63141-8232
Phone
(314) 251-6382
Fax
(314) 251-4454
NPI assigned
Feb 6, 2007
Last updated
Apr 30, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HOSPITALS EAST COMMUNITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Authorized official

Name
Jeffrey A. Johnston
Title
President
Phone
(314) 251-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

621 S New Ballas Rd
Saint Louis, MO 63141-8232

Mailing address

621 S New Ballas Rd
Saint Louis, MO 63141-8232
Phone (314) 251-6382

Other identifiers 1

IdentifierTypeStateIssuer
505812800MedicaidMO

Other names 1

  • Mercy JFK Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Mercy Hospitals East Communities Mercy Hospital St Louis

Locations

621 S New Ballas Rd
#H
Saint Louis, MO 63141
Phone (314) 251-4283

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1265572812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6382",
            "fax_number": "314-251-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-6382",
            "fax_number": "314-251-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY SUPPORT SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITALS EAST COMMUNITIES",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-251-6000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "505812800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy JFK Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 30, 2012; 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.