NPIMap

Organization Active NPI

St Louis Childrens Hospital

Doing business as Children's Hospital Specialty Care Center Pharmacy

  • Community/Retail Pharmacy
  • Town and Country, MO
National Provider Identifier
1629464847
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ST LOUIS CHILDRENS HOSPITAL
Doing business as
Children's Hospital Specialty Care Center Pharmacy
Practice address
13001 N Outer 40 Rd
Town and Country, MO 63017-5941
Phone
(314) 454-3232
Fax
(314) 454-3233
NPI assigned
Apr 14, 2015
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Mrs. Michele McKee
Title
Vice President
Phone
(314) 454-6044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X MO Primary

Addresses

Primary practice location

13001 N Outer 40 Rd
Town and Country, MO 63017-5941

Mailing address

13001 N Outer 40 Rd
Town and Country, MO 63017-5941
Phone (314) 454-3232

Other names 1

  • Children's Hospital Specialty Care Center Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100422000171 MO Part A Provider - Hospital 5294838678 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chesterfield, MO; Florissant, MO; O Fallon, MO; Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629464847. Details of each certification follow.

Hospital certification: CCN 263301

Legal name
ST LOUIS CHILDRENS HOSPITAL
Doing business as
ST LOUIS CHILDRENS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jan 1, 1984
Last certification
Apr 28, 2003
Beds
235
Ownership / control type
Other
Organization structure
CorporationNon-profit
Enrollment address
1 Childrens PL
Saint Louis, MO 63110-1002
Main/Primary Hospital Location
Hospital subgroups
Children’s

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
St Louis Childrens HospitalCCN 263301 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
St Louis Childrens Hosp10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 36

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gabriela Ramirez-Arellano Individual Corporate DirectorBoard Member Jan 1, 2023
Operational/Managerial ControlBoard Member Jan 1, 2023
Bethany Johnson-Javois Individual Corporate DirectorBoard Member Jan 1, 2026
Richard McClure Individual Corporate DirectorBoard Member Jan 1, 2015
Operational/Managerial ControlBoard Member Jan 1, 2015
Nancy Anne Diemer Individual Corporate Director Mar 10, 2010
Operational/Managerial ControlBoard Member Oct 3, 2007
Michele McKee Individual Corporate OfficerChief Financial Officer Mar 11, 2013
Corporate DirectorChief Financial Officer Mar 11, 2013
W-2 Managing EmployeeChief Financial Officer Mar 11, 2013
Operational/Managerial ControlChief Financial Officer Mar 11, 2013
Beverly Sobchak Brozanski Individual Corporate OfficerVice President Jan 1, 2020
W-2 Managing EmployeeVice President Jan 1, 2020
Operational/Managerial ControlVice President Jan 1, 2020
Keir Gumbs Individual Corporate DirectorBoard Member Jan 1, 2026
Richard a Short Individual Corporate DirectorBoard Member Jan 1, 2011
Operational/Managerial ControlBoard Member Jan 1, 2011
Paul J Scheel Individual Corporate DirectorBoard Member Jan 1, 2026
John P Stupp Individual Corporate DirectorBoard Member Jan 1, 2026
James S McDonnell Individual Corporate Officer Jan 1, 2020
Corporate Director Mar 10, 2010
Lashonda Barnes Individual Corporate Director Jan 1, 2020
Operational/Managerial Control Jan 1, 2020
Megan Lane Individual Corporate DirectorBoard Member Jan 1, 2026
Pamela Malone Individual Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial ControlBoard Member Jan 1, 2021
Karlos Ramirez Individual Corporate DirectorBoard Member Jan 1, 2018
Operational/Managerial ControlBoard Member Jan 1, 2018
Tracey Aegerter Individual Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial ControlBoard Member Jan 1, 2022
Trisha M Lollo Individual Corporate OfficerPresident Sep 1, 2019
W-2 Managing EmployeePresident Sep 1, 2019
Operational/Managerial ControlPresident Sep 1, 2019
Robert C Mueller Individual Corporate DirectorBoard Member Jan 1, 2019
Operational/Managerial ControlBoard Member Jan 1, 2019
St Louis Childrens Hospital Organization, Saint Louis, MO Non-profit Operational/Managerial Control Jul 27, 1994
Arteveld McCoy Individual Corporate DirectorBoard Member Jan 1, 2019
Operational/Managerial ControlBoard Member Jan 1, 2019
James Clayborne Individual Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial ControlBoard Member Jan 1, 2022
Rodney Crim Individual Corporate DirectorBoard Member Mar 20, 2020
Operational/Managerial Control Mar 20, 2020
Eric C Rhone Individual Corporate DirectorBoard Member Mar 10, 2010
Operational/Managerial ControlBoard Member Dec 1, 2006
Robert W. Cannon Individual Corporate OfficerBoard Member Jan 1, 2026
Corporate DirectorBoard Member Jan 1, 2026
Robert C Imbs Individual Corporate DirectorBoard Member Mar 10, 2010
Operational/Managerial ControlBoard Member Jan 1, 2002
David H Perlmutter Individual Corporate DirectorBoard Member Dec 1, 2015
Operational/Managerial ControlBoard Member Dec 1, 2015
Birch M Mullins Individual Corporate Director Mar 10, 2010
Operational/Managerial ControlBoard Member Jan 1, 1994
James Williams Individual Corporate DirectorBoard Member Jan 1, 2019
Operational/Managerial ControlBoard Member Jan 1, 2019
Tracy E Hart Individual Corporate DirectorBoard Member Mar 10, 2010
Operational/Managerial ControlBoard Member Jun 2, 2009
Scott Hawig Individual Corporate OfficerVice President, Finance Jan 1, 2026
Operational/Managerial ControlVice President, Finance Jan 1, 2026
Steve Lindsey Individual Corporate DirectorBoard Member Mar 5, 2015
Operational/Managerial ControlBoard Member Mar 5, 2015
Latesha Jewell Individual Corporate OfficerVice President Jan 3, 2022
W-2 Managing EmployeeVice President Jan 3, 2022
Operational/Managerial ControlVice President Jan 3, 2022
Robert R Hermann Individual Corporate DirectorBoard Member Mar 10, 2010
Operational/Managerial ControlBoard Member Jan 1, 2002
Carrie Lee Individual Corporate Officer Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Chris Hagedorn Individual Corporate DirectorBoard Member Jan 1, 2015
Operational/Managerial ControlBoard Member Jan 1, 2015
Donald M Suggs Individual Corporate DirectorBoard Member Mar 10, 2010
Operational/Managerial ControlBoard Member Jan 1, 1998

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 65

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 65

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1629464847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 N OUTER 40 RD",
            "city": "TOWN AND COUNTRY",
            "state": "MO",
            "postal_code": "630175941",
            "telephone_number": "314-454-3232",
            "fax_number": "314-454-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13001 N OUTER 40 RD",
            "city": "TOWN AND COUNTRY",
            "state": "MO",
            "postal_code": "630175941",
            "telephone_number": "314-454-3232",
            "fax_number": "314-454-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LOUIS CHILDRENS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "314-454-6044",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "13001 N Outer 40 Rd",
            "city": "Town and Country",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630175941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Children's Hospital Specialty Care Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Town and Country, MO

Sources for this page

Verify at the official NPI Registry.