NPIMap

Organization Active NPI

St. Lukes Episcopal-Presbyterian Hospital

  • Skilled Nursing Facility
  • Chesterfield, MO
National Provider Identifier
1841473022
Registry record updated Feb 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
033636 Issued in MO
Legal business name
ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL
Practice address
14701 Olive Blvd
Chesterfield, MO 63017-2221
Phone
(314) 542-3300
Fax
(314) 542-3352
NPI assigned
Dec 11, 2007
Organization subpart
Yes
Parent organization
ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2012

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

Authorized official

Name
Mr. Scott H. Johnson
Title
Vice President Finance / Cfo
Phone
(314) 434-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 033636 MO Primary

Addresses

Primary practice location

14701 Olive Blvd
Chesterfield, MO 63017-2221

Mailing address

232 S Woods Mill Rd
Chesterfield, MO 63017-3417
Phone (314) 434-1500

Other identifiers 1

IdentifierTypeStateIssuer
100567601MedicaidMO

Other names 1

  • St. Luke's Hospital Surrey Place Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051027000133 MO Part A Provider - Skilled Nursing Facility 0042116295 Practice locations: Chesterfield, MO

Skilled nursing facility certification: CCN 265414

Legal name
ST LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL
Doing business as
SURREY PLACE ST LUKE'S HOSPITAL SKILLED NURSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Jan 30, 1990
Last certification
Aug 1, 2024
Beds
130
Ownership / control type
Nonprofit Corporation
Multi-facility organization
ST LUKES HOSPITAL
Organization structure
CorporationNon-profit
Enrollment address
14701 Olive Blvd
Chesterfield, MO 63017-2221
Nursing home name
SURREY PLACE ST LUKES HOSPITAL SKILLED NURSING

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: Nursing home

Medicare Care Compare
Listed as
Surrey Place St Lukes Hospital Skilled NursingCCN 265414
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 30, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13080.6 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D0701333St Lukes Hospital Surrey Place14701 Olive Street, Chesterfield, MO 63017Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Steven F Willey MD11 organizations share this tax ID, including this one
Part of
Steven F Willey MD

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
St Lukes Episcopal-Presbyterian Hospital Organization, Chesterfield, MO Created for acquisition, Corporation 5% Or Greater Direct Ownership Interest Jan 30, 1990 100%
Operational/Managerial Control Jul 1, 2024
Direct Ownership Interest Jul 1, 2024 100%
Daniel K Stegmann Individual Corporate OfficerBoard Member Sep 16, 2013
Managing Control - Governing BodyBoard Member Jul 1, 2024
David B Price Individual Corporate OfficerChairman Jul 1, 2021
Managing Control - Governing BodyBoard Member Jul 1, 2024
Gina G Ivie Individual Corporate DirectorDirector of Finance Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
James M Snowden Individual Corporate OfficerSecretary Jul 1, 2021
Managing Control - Governing BodyBoard Member Jul 1, 2024
Jason M Edwards Individual Corporate OfficerBoard Member Jul 1, 2021
Managing Control - Governing BodyBoard Member Jul 1, 2024
Jeffrey Boesch Individual Corporate DirectorMedical Director Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jan 28, 2025
Andrew J Bagnall Individual Corporate OfficerCeo Aug 15, 2022
Operational/Managerial Control Jul 1, 2024
Jonathan Vitiello Individual Corporate OfficerSr VP & Cfo Mar 1, 2024
Operational/Managerial Control Jul 1, 2024
Susan Franklin Individual Corporate DirectorAdministrator Jul 1, 2024
Operational/Managerial Control Jul 1, 2024
Adp of the SNF Jul 1, 2024
Edward Glotzbach Individual Corporate OfficerTreasurer Jan 1, 2016
Managing Control - Governing BodyBoard Member Jul 1, 2024
Cynthia Maritz Individual Corporate DirectorBoard Member Jan 1, 2017
Managing Control - Governing BodyBoard Member Jul 1, 2024
Norman L Eaker Individual Corporate DirectorBoard Member Sep 15, 2014
Managing Control - Governing BodyBoard Member Jul 1, 2024

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
St Luke'S Rehabilitation HospitalChesterfield, MO, CCN 263030 Hospital 5% Or Greater Direct Ownership Interest (40%) Apr 7, 2015
St Lukes Home Health ServicesChesterfield, MO, CCN 267561 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2009
St. Luke'S Hospice ServicesChesterfield, MO, CCN 261627 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2001

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1841473022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173417",
            "telephone_number": "314-434-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14701 OLIVE BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630172221",
            "telephone_number": "314-542-3300",
            "fax_number": "314-542-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL",
        "enumeration_date": "2007-12-11",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE / CFO",
        "authorized_official_telephone_number": "314-434-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MO",
            "license": "033636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100567601",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke's Hospital Surrey Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.