NPIMap

St. Louis Childrens Hospital

Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Saint Louis, MO

NPI 1710909486 · NPPES record last updated Mar 16, 2021

Key facts

NPI
1710909486
Entity type
Organization (NPI type 2)
Primary specialty
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Legal business name
ST. LOUIS CHILDRENS HOSPITAL
Practice address
1 Childrens PL
Saint Louis, MO 63110-1002
Phone
(314) 454-6000
NPI assigned
Jul 24, 2006
Organization subpart
No

Authorized official

Name
Michele M McKee
Title
Cfo
Phone
(314) 454-6044

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 4

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

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 9

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners 50

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

View all 50

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 (2 enrollments) 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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Louis Childrens Hospital
Saint Louis, MO · CCN 263301		 Hospital Operational/Managerial Control Jul 27, 1994

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070306000462 MO Part B Supplier - Clinic/Group Practice 5294838678 Receives reassigned benefits from 40 practitioners
1 other NPI on this enrollment
Practice locations: Chesterfield, MO; Saint Louis, MO
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)

Locations

900 W Nifong Blvd
Ste 101
Columbia, MO 65203
Phone (573) 499-9009

2536 S Old Highway 94
Ste 116
Saint Charles, MO 63303
Phone (314) 277-4062

1 Childrens Pl
Ste 3N14
Saint Louis, MO 63110
Phone (314) 454-4013

1 Childrens Pl
Ste 3S32
Saint Louis, MO 63110
Phone (727) 218-2420

13001 North Outer 40 Rd
Ste 2B
Town and Country, MO 63017
Phone (314) 454-6069

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 324-22 MO
Adolescent and Children Mental Health Clinic/Center 261QM0855X Yes

Addresses

Primary practice location

1 Childrens PL
Saint Louis, MO 63110-1002

Mailing address

1 Childrens PL
Administration, Suite 3S-36
Saint Louis, MO 63110-1002
Phone (314) 454-6044

Other practice location 1

13001 N Outer 40 Rd
Chesterfield, MO 63017-5941
Phone (314) 454-8600

Other identifiers

IdentifierTypeStateIssuer
167OtherMISSOURI BLUE CROSS
936377MedicaidIA
HOS330INMedicaidAL
103176OtherHEALTH LINK
112148105MedicaidAR
100693290AMedicaidOK
1440650MedicaidKY
95348MedicaidMS
1737518MedicaidLA
5010193OtherUNITED HEALTHCARE
518802OtherAETNA
901450100MedicaidFL
10930907MedicaidMO
17268OtherGHP AND CMR

Electronic endpoints

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

Other providers in Saint Louis, MO

All providers in Saint Louis, MO · Adolescent and Children Mental Health Clinic/Center in Missouri

Sources for this page

Verify at the official NPI Registry.