NPIMap

Organization Active NPI

Mercy Clinic Children's Surgery, LLC

  • Pediatric Surgery Physician
  • Saint Louis, MO
National Provider Identifier
1649349804
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
Legal business name
MERCY CLINIC CHILDREN'S SURGERY, LLC
Practice address
621 S. New Ballas Road
Suite 6018-B
St. Louis, MO 63141-8274
Phone
(314) 251-5940
Fax
(314) 251-5813
NPI assigned
Nov 6, 2006
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY CLINIC EAST COMMUNITIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 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 Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0120X Primary

Addresses

Primary practice location

621 S. New Ballas Road
Suite 6018-B
St. Louis, MO 63141-8274

Mailing address

621 S. New Ballas Road
Suite 6018-B
St. Louis, MO 63141-8274
Phone (314) 251-5940

Other names 1

  • Mercy Children's Surgery Associates Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191118000151 MO Part B Supplier - Clinic/Group Practice 4385076199 Receives reassigned benefits from 12 practitioners
Practice locations: Saint Louis, MO; O Fallon, MO

National Provider Directory

National Provider Directory
Part of
James G Hopper MD

Locations

12445 Dorsett Rd
Maryland Heights, MO 63043
Phone (314) 251-1820

621 S New Ballas Rd
Ste 483A
Saint Louis, MO 63141
Phone (314) 251-2095

621 S New Ballas Rd
Ste 6011B
Saint Louis, MO 63141
Phone (314) 251-7400

621 S New Ballas Rd
Ste 6018
Saint Louis, MO 63141

300 Floyd Dr
Sikeston, MO 63801
Phone (573) 472-0397

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 112

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 112

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1649349804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S. NEW BALLAS ROAD",
            "address_2": "SUITE 6018-B",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631418274",
            "telephone_number": "314-251-5940",
            "fax_number": "314-251-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S. NEW BALLAS ROAD",
            "address_2": "SUITE 6018-B",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631418274",
            "telephone_number": "314-251-5940",
            "fax_number": "314-251-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC CHILDREN'S SURGERY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2006-11-06",
        "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": "2086S0120X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Children's Surgery Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 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.