NPIMap

Organization Active NPI

St. Louis Childrens Hospital

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1710909486
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 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
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
Michele M McKee
Title
Cfo
Phone
(314) 454-6044

Specialties & licenses 2

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

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

Electronic endpoints 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710909486. 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 with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 4

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.

Locations

1021 E Highway 22
Centralia, MO 65240
Phone (573) 682-5580

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) 454-6069

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

3844 S Lindbergh Blvd
Ste 210
Saint Louis, MO 63127
Phone (314) 525-0420

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

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 4

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

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 HospitalSaint Louis, MO, CCN 263301 Hospital Operational/Managerial Control Jul 27, 1994

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 50

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 50

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": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1710909486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "ADMINISTRATION, SUITE 3S-36",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13001 N Outer 40 Rd",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630175941",
            "country_code": "US",
            "telephone_number": "314-454-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. LOUIS CHILDRENS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "314-454-6044"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MO",
            "license": "324-22",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "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": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630175941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1 Childrens Pl",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.