NPIMap

Organization Active NPI

Mercy Clinic East Communities

  • Family Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1720635329
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MERCY CLINIC EAST COMMUNITIES
Practice address
10004 Kennerly Rd Ste 395B
Saint Louis, MO 63128-2190
Phone
(314) 849-3500
Fax
(314) 543-5951
NPI assigned
Aug 20, 2019
Last updated
Apr 28, 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 28, 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
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

10004 Kennerly Rd Ste 395B
Saint Louis, MO 63128-2190

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (314) 364-4347

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070521000006 MO Part B Supplier - Clinic/Group Practice 7214827922 Receives reassigned benefits from 780 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20070521000058 MO Part B Supplier - Clinic/Group Practice 7214827922 Receives reassigned benefits from 211 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Washington, MO; Warrenton, MO; Union, MO; Troy, MO; Sullivan, MO; Saint Clair, MO; Pacific, MO; New Haven, MO…

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Part of
Mercy Clinic Communities

Locations

17701 Edison Ave
Ste 101
Chesterfield, MO 63005
Phone (636) 735-4122

10004 Kennerly Rd
Ste 230A
Saint Louis, MO 63128
Phone (314) 525-1800

7345 Watson Rd
Ste 202
Saint Louis, MO 63119
Phone (314) 752-7100

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 91

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 91

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1720635329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "314-364-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 395B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282190",
            "telephone_number": "314-849-3500",
            "fax_number": "314-543-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY CLINIC EAST COMMUNITIES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2019-08-20",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 28, 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.