Organization Active NPI

SSM Health Care St. Louis

Doing business as SSM Health St. Mary's Hospital - St. Louis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1831278332
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
383-13 Issued in MO
Legal business name
SSM HEALTH CARE ST. LOUIS
Doing business as
SSM Health St. Mary's Hospital - St. Louis
Practice address
6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone
(314) 768-8000
NPI assigned
Nov 3, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SSM HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Mr. Travis Capers
Title
President
Phone
(314) 768-8052

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 383-13 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
Saint Louis, MO 63117-1811

Mailing address

6420 Clayton Rd
Saint Louis, MO 63117-1811
Phone (314) 768-8000

Other names 1

  • SSM Health St. Mary's Hospital - St. Louis Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160205002104 MO Part A Provider - End-Stage Renal Disease Facility (ESRD) 7810800737 Practice locations: Saint Louis, MO

Other NPIs with the same Medicare PAC ID 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
David a Kelley MD15 organizations share this tax ID, including this one
Part of
SSM Health Care Corporation

Other organizations with this tax ID 14

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

View all 14

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 11

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

FacilityTypeRoleSince
SSM Health St. Clare Hospital - FentonFenton, MO, CCN 260081 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Rehabilitation HospitalRichmond Heights, MO, CCN 263031 Hospital 5% Or Greater Direct Ownership Interest (49%) May 1, 2009
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 260105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health Saint Louis University HospitalSaint Louis, MO, CCN 26S105 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2015
SSM Health St Joseph Hospital - Lake Saint LouisLake Saint Louis, MO, CCN 260200 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 17, 2014
SSM Health St Joseph Hospital - St CharlesSaint Charles, MO, CCN 260005 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Sep 11, 1984
Oct 12, 2015
SSM Health St. Mary's Hospital - St. LouisSaint Louis, MO, CCN 26S091 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 13, 2014
SSM Health St. Mary's Hospital - St LouisSaint Louis, MO, CCN 260091 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 11, 1984
SSM Health Depaul Hospital St LouisBridgeton, MO, CCN 26S104 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2013
SSM Health Depaul Hospital - St LouisBridgeton, MO, CCN 260104 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 10, 2014
SSM Health Depaul Hospital - Anna HouseBridgeton, MO, CCN 265842 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Sep 1, 2015

Owned or controlled facilities with NPI records 12

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1831278332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SSM HEALTH CARE ST. LOUIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SSM HEALTH CARE CORPORATION",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "CAPERS",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-768-8052",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MO",
            "license": "383-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SSM Health St. Mary's Hospital - St. Louis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health St. Mary's Hospital - St. Louis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.