NPIMap

St Louis Childrens Hospital

Organization Active NPI Community/Retail Pharmacy · Town and Country, MO

NPI 1629464847 · NPPES record last updated Mar 16, 2021

Key facts

NPI
1629464847
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
ST LOUIS CHILDRENS HOSPITAL
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
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 5

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

Other NPIs on the same Medicare enrollment 3

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

Corporate family (same tax ID) 9

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

Affiliated clinicians 65

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

View all 65

Medicare Care Compare: Hospital

Listed as
St Louis Childrens Hospital CCN 263301
Type
Childrens
Ownership
Voluntary non-profit - Other
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO

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
Corporation · Non-profit
Enrollment address
1 Childrens PL
Saint Louis, MO 63110-1002
Main/Primary Hospital Location
Hospital subgroups
Children’s

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

Medicare enrollment records

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

National Provider Directory

Tax ID family
St Louis Childrens Hospital (10 organizations share this tax ID)

Specialties & licenses

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

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

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

Electronic endpoints

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

Other providers in Town and Country, MO

All providers in Town and Country, MO · Community/Retail Pharmacy in Missouri

Sources for this page

Verify at the official NPI Registry.