NPIMap

Organization Active NPI

Saint Lukes South Hospital, Inc.

  • Rehabilitation Hospital Unit
  • Overland Park, KS
National Provider Identifier
1790767812
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
SAINT LUKES SOUTH HOSPITAL, INC.
Practice address
12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone
(913) 317-7000
NPI assigned
Nov 15, 2005
Last updated
Sep 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT LUKES SOUTH HOSPITAL , INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew L Marino
Title
Vice President
Phone
(816) 347-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

12300 Metcalf Ave
Overland Park, KS 66213-1324

Mailing address

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

Other identifiers 2

IdentifierTypeStateIssuer
013990007MedicaidMO
100332210AMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4 Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090224000171 KS Part A Provider - Hospital 9931183969 Practice locations: Overland Park, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790767812. Details of each certification follow.

Hospital certification: CCN 17T185

Legal name
SAINT LUKE'S SOUTH HOSPITAL INC
Doing business as
ST LUKE'S SOUTH HOSPITAL INC
Organization structure
CorporationNon-profit
Incorporated
May 8, 1998 in KS
Enrollment address
12300 Metcalf Ave
Overland Park, KS 66213-1324
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Saint Lukes South HospitalCCN 17T185 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2007

National Provider Directory

National Provider Directory
Tax ID family
Julie a Martin MD5 organizations share this tax ID, including this one
Part of
Julie a Martin MD

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Robert L Olm-Shipman Individual Corporate OfficerCeo Sep 8, 2015
Corporate DirectorBoard Member Sep 8, 2015
W-2 Managing EmployeeCeo Sep 8, 2015
James P O'Hara Individual Corporate DirectorBoard Member Jan 1, 2022
Charles Horner Individual Corporate DirectorBoard Member May 31, 2023
Matthew Marino Individual Corporate Officer Jan 1, 2018
W-2 Managing EmployeeCfo Jan 1, 2019
Willie F Pegues Individual Corporate DirectorBoard Member Jan 1, 2022
Saint Lukes Health System Inc Organization, Kansas City, MO Non-profit 5% Or Greater Direct Ownership Interest Nov 30, 1998 100%
BJC Health System Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Matthew D Sheets Individual Corporate DirectorBoard Member Jan 1, 2022
Wendy Guillies Individual Corporate DirectorBoard Member Jan 1, 2018
Stephanie S Clayton Individual Corporate DirectorBoard Member Jan 1, 2024
Daniel C Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Julie Quirin Individual Corporate OfficerSLHS President Jan 1, 2024
David B Parmet Individual Corporate DirectorBoard Member Jan 1, 2024
Sanjeev Khurana Individual Corporate DirectorBoard Member Jan 1, 2018
Christine Ricci Individual Corporate DirectorBoard Member May 31, 2023

Owners & managing parties with NPI records 1

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

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners & affiliated clinicians

Affiliated clinicians 10

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

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1790767812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-317-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 METCALF AVE",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662131324",
            "telephone_number": "913-317-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LUKES SOUTH HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT LUKES SOUTH HOSPITAL , INC.",
        "enumeration_date": "2005-11-15",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "816-347-5000"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013990007",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100332210A",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12300 Metcalf Ave",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662131324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.