Mercy Clinic Child Neurology, LLC

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

Legal business name

MERCY CLINIC CHILD NEUROLOGY, LLC

Practice address

621 S New Ballas Rd
Suite 5009-B
Saint Louis, MO 63141-8232

Phone

(314) 251-5866

Fax

(314) 251-5867

NPI assigned

Feb 9, 2011

Organization subpart

Yes

Parent organization

MERCY CLINIC EAST COMMUNITIESAs reported in NPPES

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

Addresses

Other names 1

• Mercy Child Neurology Former legal business name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Part of

St John'S Mercy Medical Group

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
  • NPI 1720635329

  Member Of

  NPD member

Locations

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.

• Mercy Clinic East Communities

  • Endocrinology, Diabetes & Metabolism Physician
  • Ballwin, MO
  • NPI 1700370061
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ali Ayman Jamal, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Saint Louis, MO
  • NPI 1184980716
  Medicare reassignment NPD
• Himanshu Uday Kaulas, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Saint Louis, MO
  • NPI 1801186044
  Medicare reassignment NPD
• Katherine Marie Shine, MSN, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
  • NPI 1427482157
  Medicare reassignment NPD
• Srikanth Thalakoti

  • Pediatric Neurodevelopmental Disabilities Physician
  • Saint Louis, MO
  • NPI 1912132663
  Medicare reassignment NPD

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1285930206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 5009-B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5866",
            "fax_number": "314-251-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 5009-B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-251-5866",
            "fax_number": "314-251-5867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC CHILD NEUROLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2011-02-09",
        "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": "2084N0402X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Child Neurology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Neurology with Special Qualifications in Child Neurology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Missouri

• 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.