Organization Active NPI

Mercy Clinic Children'S Cancer & Hematology LLC

  • Pediatric Hematology & Oncology Physician
  • Creve Coeur, MO
National Provider Identifier
1407066343
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
Legal business name
MERCY CLINIC CHILDREN'S CANCER & HEMATOLOGY LLC
Practice address
607 S New Ballas Rd
Suite 2415
Creve Coeur, MO 63141-8219
Phone
(314) 251-6986
Fax
(314) 251-5712
NPI assigned
May 22, 2007
Organization subpart
Yes
Parent organization
MERCY CLINIC EAST COMMUNITIESAs 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 Hematology & Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0207X Primary

Addresses

Primary practice location

607 S New Ballas Rd
Suite 2415
Creve Coeur, MO 63141-8219

Mailing address

607 S New Ballas Rd
Suite 2415
Creve Coeur, MO 63141-8219
Phone (314) 251-6986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000802 MO Part B Supplier - Clinic/Group Practice 0345401477 Receives reassigned benefits from 6 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

615 S New Ballas Rd
Ste 120
Saint Louis, MO 63141
Phone (314) 251-6986

607 S New Ballas Rd
Ste 2415
Saint Louis, MO 63141
Phone (314) 251-5399

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 7

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1407066343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD",
            "address_2": "SUITE 2415",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-6986",
            "fax_number": "314-251-5712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S NEW BALLAS RD",
            "address_2": "SUITE 2415",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631418219",
            "telephone_number": "314-251-6986",
            "fax_number": "314-251-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC CHILDREN'S CANCER & HEMATOLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2007-05-22",
        "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": "2080P0207X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, 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.