NPIMap

Organization Active NPI

Shriners Hospitals for Children

  • Children's Hospital
  • Saint Louis, MO
National Provider Identifier
1942343447
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
142-53 Issued in MO
Legal business name
SHRINERS HOSPITALS FOR CHILDREN
Practice address
4400 Clayton Avenue
St. Louis, MO 63110-1624
Phone
(314) 432-3600
Fax
(314) 432-2930
NPI assigned
Feb 14, 2007
Last updated
Jun 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Authorized official

Name
Mr. John Gloss, FACHE
Title
Administrator
Phone
(314) 432-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 142-53 MO Primary

Addresses

Primary practice location

4400 Clayton Avenue
St. Louis, MO 63110-1624

Mailing address

PO Box 8500
Lockbox #7642
Philadelphia, PA 19178-7642
Phone (813) 281-8478

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220113001232 MO Part A Provider - Hospital 9133031933 Practice locations: Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942343447. Details of each certification follow.

Hospital certification: CCN 263304

Legal name
SHRINERS HOSPITALS FOR CHILDREN
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Mar 2, 2011
Last certification
Mar 2, 2011
Beds
80
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
4400 Clayton Ave
Saint Louis, MO 63110-1624
Main/Primary Hospital Location
Hospital subgroups
Acute care, Children’s

Care Compare: Hospital

Medicare Care Compare
Listed as
Shriners Hospitals for ChildrenCCN 263304 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
Kevin R Costello Individual Corporate Officer1St Vice President Jul 4, 2024
Corporate Director Jul 7, 2016
William B. Rasner Individual Corporate DirectorTrustee Jul 7, 2022
Jim L Cain Individual Corporate Director Jul 3, 2008
Matthew Sturlaugson Individual Corporate OfficerAssistant Secretary Jul 4, 2024
Corporate Director Jul 12, 2020
Lawrence J Leib Individual Corporate Officer2ND Vice President Jul 4, 2024
Corporate Director Jul 13, 2017
James E Stolze Individual Corporate Director Jul 9, 2015
Dale R. Vrsalovich Individual Corporate DirectorDirector Jul 4, 2024
Martin L. Bartlett Individual Corporate DirectorDirector Jul 12, 2020
John P McCabe Individual W-2 Managing Employee Mar 2, 2011
Ronald Capps Individual Corporate DirectorTrustee Jul 4, 2024
Phillip L Grady Individual W-2 Managing EmployeeVP Hospital Operations Sep 1, 2019
David C. Hamm Individual Corporate Director Jul 6, 2023
Samantha Marie Amos Individual W-2 Managing EmployeeDirector Fiscal Services Oct 11, 2022
Timothy L. Ludwig Individual Corporate DirectorTrustee Jul 6, 2023
Mark E Hartz Individual Corporate OfficerSecretary Jul 4, 2024
Corporate Director Jul 19, 2018
Leslie D Stewart Individual Corporate OfficerPresident Jul 4, 2024
Corporate Director Jul 12, 2020
Timothy D Forbis Individual Corporate Director Jul 8, 2021
Brad T Koehn Individual Corporate OfficerTreasurer Jul 13, 2017
Corporate Director Jul 13, 2017
Mark L. Venable Individual W-2 Managing EmployeeAdministrator Aug 18, 2022
Kenneth G Craven Individual Corporate DirectorTrustee Jul 10, 2014
Ronald Devoll Individual Corporate Director Jul 7, 2022
Barbara Lynn Hancher Individual W-2 Managing EmployeeDirector of Patient Care Services Jan 6, 2023
Shriners Hospitals for Children Organization, Tampa, FL Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Operational/Managerial Control Jan 1, 1966 100%
Richard G Burke Individual Corporate OfficerChairman, Board of Directors Jul 4, 2024
Corporate Director Jul 7, 2016

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Shriners Hospitals for ChildrenPhiladelphia, PA, CCN 393309 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jun 24, 1966
Jun 24, 1966
Shriners Hospitals for ChildrenPortland, OR, CCN 383300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 15, 1966
Jan 15, 2015
Shriners Hospitals for ChildrenGalveston, TX, CCN 453311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 20, 1966
Mar 20, 1966
Shriners Hospitals for ChildrenHonolulu, HI, CCN 123301 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 1, 2013
Oct 1, 2013
Shriners Hospitals for ChildrenSacramento, CA, CCN 053311 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Apr 15, 1997
Apr 15, 1997
Shriners Hospitals for ChildrenGreenville, SC, CCN 423300 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Aug 20, 2013
Jul 15, 2010
Shriners Children's OhioDayton, OH, CCN 363308 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 19, 1968
Feb 19, 1968
Shriners Hospitals for ChildrenChicago, IL, CCN 143302 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 1966
Jan 1, 1966

Facilities with the same owner 8

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1942343447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500",
            "address_2": "LOCKBOX #7642",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191787642",
            "telephone_number": "813-281-8478",
            "fax_number": "813-281-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 CLAYTON AVENUE",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631101624",
            "telephone_number": "314-432-3600",
            "fax_number": "314-432-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRINERS HOSPITALS FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "GLOSS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-432-3600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "MO",
            "license": "142-53",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.