NPIMap

Organization Active NPI

Mercy Clinic St. Louis Cancer and Breast Institute, LLC

  • Surgical Oncology Physician
  • Saint Louis, MO
National Provider Identifier
1891946349
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
Legal business name
MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC
Practice address
621 S New Ballas Rd Ste 260a
Saint Louis, MO 63141-8256
Phone
(314) 251-8001
Fax
(314) 256-5043
NPI assigned
Oct 2, 2008
Last updated
Apr 25, 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 25, 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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology (Internal Medicine) Physician 207RH0000X NU
Medical Oncology Physician 207RX0202X NU
Radiation Oncology Physician 2085R0001X NU
Surgical Oncology Physician 2086X0206X NU Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 260a
Saint Louis, MO 63141-8256

Mailing address

15945 Clayton Rd
Suite 120
Ballwin, MO 63011-2490
Phone (636) 256-5000

Other practice location 1

15945 Clayton Rd
Suite 120
Ballwin, MO 63011-2490
Phone (636) 256-5000

Other identifiers 1

IdentifierTypeStateIssuer
504721903MedicaidMO

Other names 1

  • ST LOUIS CANCER AND BREAST INSTITUTE Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000867 MO Part B Supplier - Clinic/Group Practice 9739240037 Receives reassigned benefits from 12 practitioners
Practice locations: Ballwin, MO; Saint Louis, MO

National Provider Directory

National Provider Directory
Part of
Unity Medical Group Wes

Member of 2

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

Locations

1390 US Highway 61
Ste N100
Crystal Cty, MO 63028

10050 Kennerly Rd
Ste 1500
Saint Louis, MO 63128
Phone (314) 525-1545

12348 Old Tesson Rd
Ste 120
Saint Louis, MO 63128
Phone (314) 467-3860

12634 Olive Blvd
Saint Louis, MO 63141
Phone (314) 434-0600

607 S New Ballas Rd
Ste 2310
Saint Louis, MO 63141

607 S New Ballas Rd
Ste 2350
Saint Louis, MO 63141
Phone (314) 251-1340

607 S New Ballas Rd
Ste 3100
Saint Louis, MO 63141
Phone (314) 251-4260

621 S New Ballas Rd
#206A
Saint Louis, MO 63141

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 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1891946349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD",
            "address_2": "SUITE 120",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112490",
            "telephone_number": "636-256-5000",
            "fax_number": "314-989-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 260A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418256",
            "telephone_number": "314-251-8001",
            "fax_number": "314-256-5043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15945 Clayton Rd",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630112490",
            "country_code": "US",
            "telephone_number": "636-256-5000",
            "fax_number": "314-989-1323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY CLINIC ST. LOUIS CANCER AND BREAST INSTITUTE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY CLINIC EAST COMMUNITIES",
        "enumeration_date": "2008-10-02",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "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": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504721903",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST LOUIS CANCER AND BREAST INSTITUTE",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "ST LOUIS CANCER AND BREAST INSTITUTE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 25, 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.