Covered Entity Details

DSH260138F ST. LUKE'S HOSPITAL OF KANSAS CITY (Active) - information as of 5/13/2025 10:54:05 PM

Main Details

Name

ST. LUKE'S HOSPITAL OF KANSAS CITY

Subdivision Name

Saint Luke's Heart Transplant Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260138F

Medicare Provider Number

260138

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/15/2014

Participating Start Date

1/1/2015

Participating Approval Date

12/8/2014

Last Recertification Date

8/22/2024

Contacts

Authorizing Official

Saint Luke's Hospital of Kansas City
Amy Nachtigal, VP Finance
(816) 932-3318

Primary Contact

Saint Luke's Hospital of Kansas City
Connor Matthew Flanagin, Director of Pharmacy
(816) 932-2431

Addresses

Street Address

4321 Washington Street
Medical Plaza III Suite 2100
Kansas City, MO 64111

Billing Address

Saint Luke's Hospital
PO Box 5870
Kansas City, MO 64171-0870

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
MO	10326106,600012785	1063494177,1134566409

Shipping Addresses

Shipping Address 1

Saint Luke's Hospital
4401 Wornall Road
Kansas City, MO 64111

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH260138A	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	ST. LUKE'S HOSPITAL INFUSION CENTER, DR. TIMOTHY PLUARD	4321 WASHINGTON	KANSAS CITY	MO	Terminated
DSH260138B	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	SLH Infusion Center at SLEH	110 NE St Lukes Blvd	LEE'S SUMMIT	MO	Active
DSH260138C	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke’s Infusion Center – South	12330 Metcalf Ave	Overland Park	KS	Active
DSH260138D	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	SLH Abdominal Transplant and Multispecialty Clinic	4321 Washinton St	Kansas City	MO	Active
DSH260138E	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Kidney Transplant Clinic	4321 Washington St Suite 4000	Kansas City	MO	Active
DSH260138F	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Heart Transplant Clinic	4321 Washington Street	Kansas City	MO	Active
DSH260138G	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	INFUSION CENTER AT CREEKWOOD	5400 N OAK TRFY	KANSAS CITY	MO	Terminated
DSH260138H	Child	DSH	ST. LUKES HOSPITAL OF KANSAS CITY	SAINT LUKE'S TRANSPLANT EVALUATION	1035 N EMPORIA	WICHITA	KS	Terminated
DSH260138J	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	SAINT LUKE'S HOSPITAL-INFUSION CENT	2529 GLENN HENDREN DR	LIBERTY	MO	ToBeTerminated
DSH260138K	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Women's Care	4320 Wornall Road	Kansas City	MO	Active
DSH260138L	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Multispecialty Clinic	4320 Wornall Road	Kansas City	MO	Active
DSH260138M	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Pain Management Clinic	4321 Washington Street	Kansas City	MO	Active
DSH260138N	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists - Liberty / Medical Oncology - Liberty -973980	2529 Glenn Hendren Dr. Suite G20	Liberty	MO	ToBeTerminated
DSH260138P	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists - North / Medical Oncology - North - 973950	5400 North Oak Trfwy Suite 101	Kansas City	MO	Terminated
DSH260138Q	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists - Lee's Summit / Medical Oncology - East - 973940	110 North East Saint Luke's Blvd Suite 500	Lee's Summit	MO	Active
DSH260138R	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists - South / Medical Oncology - South - 973930	12330 Metcalf Avenue Suite 580	Overland Park	KS	Active
DSH260138S	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists / Medical Oncology Practice 718100	4321 Washington Street Suite 4000	Kansas City	MO	Terminated
DSH260138T	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Cancer Specialists / Gynecology Oncology 718050	4321 Washington Street Suite 4000	Kansas City	MO	Terminated
DSH260138U	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Hospital Koontz Center for Advanced Breast Cancer	4321 Washington St.	Kansas City	MO	Terminated
DSH260138V	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	Saint Luke's Hospital Valve and Vascular Clinic - Saint Luke's Hospital Valve and Vascular Clinic	4320 Wornall Rd.	Kansas City	MO	Active
DSH260138W	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	SAINT LUKES CANCER SPECIALIST NORTH - Oncology	5844 NW BARRY RD	KANSAS CITY	MO	Active
DSH260138X	Child	DSH	ST. LUKE'S HOSPITAL OF KANSAS CITY	SAINT LUKES HOSPITAL INFUSION CENTE - Oncology	5844 NW BARRY RD	KANSAS CITY	MO	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Group Change Request	Little, Jeff Director of Pharmacy Saint Luke's Hospital 8169322408	Flanagin, Connor Matthew Director of Pharmacy Saint Luke's Hospital of Kansas City 8169322431	4/14/2025 2:03 PM
Contacts	Authorizing Official	Update	Profile Change Request	Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	Nachtigal, Amy VP Finance Saint Luke's Hospital of Kansas City 8169323318	4/14/2025 1:59 PM
Contacts	Signed By	Update	Profile Change Request	Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	Nachtigal, Amy VP Finance Saint Luke's Hospital of Kansas City 8169323318	4/14/2025 1:59 PM
Details	Last Recertification Date	Update	Recertification	8/17/2023 2:37:10 PM	8/22/2024 7:11:16 PM	8/22/2024 7:11 PM
Addresses	Billing Address	Update	Recertification	Saint Luke's Hospital PO Box 5870 Kansas City, MO 64717-0870	Saint Luke's Hospital PO Box 5870 Kansas City, MO 64171-0870	8/17/2023 2:37 PM
Details	Last Recertification Date	Update	Recertification	9/1/2022 12:54:08 PM	8/17/2023 2:37:10 PM	8/17/2023 2:37 PM
Details	Last Recertification Date	Update	Recertification	9/9/2021 8:35:55 AM	9/1/2022 12:54:08 PM	9/1/2022 12:54 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Group Change Request		False	12/16/2021 8:55 AM
Medicaid Billing	Medicaid: Number	Insert	Group Change Request		600012785	12/16/2021 8:55 AM
Medicaid Billing	Medicaid: State	Insert	Group Change Request		MO	12/16/2021 8:55 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/14/2021 11:41 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		10326106	12/14/2021 11:41 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MO	12/14/2021 11:41 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1063494177	12/14/2021 11:41 PM
Medicaid Billing	NPI: State	Insert	Change Request		MO	12/14/2021 11:41 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1134566409	12/14/2021 11:41 PM
Medicaid Billing	NPI: State	Insert	Change Request		MO	12/14/2021 11:41 PM
Addresses	Billing Address	Insert	Recertification		Saint Luke's Hospital PO Box 5870 Kansas City, MO 64717-0870	9/9/2021 8:35 AM
Addresses	Shipping Address	Insert	Recertification		Saint Luke's Hospital 4401 Wornall Road Kansas City, MO 64111	9/9/2021 8:35 AM
Details	Last Recertification Date	Update	Recertification	8/31/2020 10:29:33 AM	9/9/2021 8:35:55 AM	9/9/2021 8:35 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	010326106 (MO)		6/15/2021 12:41 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1063494177 (MO)		6/15/2021 12:41 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1063494177	8/31/2020 10:29 AM
Medicaid Billing	NPI: State	Insert	Recertification		MO	8/31/2020 10:29 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1063494177 ( )		8/31/2020 10:29 AM
Details	Last Recertification Date	Update	Recertification	8/20/2019 2:39:02 PM	8/31/2020 10:29:33 AM	8/31/2020 10:29 AM
Details	Last Recertification Date	Update	Recertification	8/29/2018 10:42:05 AM	8/20/2019 2:39:02 PM	8/20/2019 2:39 PM
Details	Last Recertification Date	Update	Recertification	11/29/2017 5:31:38 PM	8/29/2018 10:42:05 AM	8/29/2018 10:42 AM
Details	Entity Name	Update	Recertification	ST. LUKES HOSPITAL OF KANSAS CITY	ST. LUKE'S HOSPITAL OF KANSAS CITY	11/29/2017 7:44 PM
Details	Last Recertification Date	Update	Recertification	8/16/2016 12:00:00 AM	11/29/2017 5:31:38 PM	11/29/2017 5:31 PM
Contacts	Authorizing Official	Update		Nachtigal, Amy CFO 8169323318	Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	10/25/2017 2:23 PM
Contacts	Signed By	Update		Nachtigal, Amy CFO 8169323318	Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	10/25/2017 2:23 PM
Contacts	Primary Contact	Update		Little, Jeff Director of Pharmacy 8169322408	Little, Jeff Director of Pharmacy Saint Luke's Hospital 8169322408	10/9/2017 2:19 PM
Contacts	Authorizing Official	Insert			Nachtigal, Amy CFO 8169323318	7/24/2017 6:51 PM
Contacts	Signed By	Insert			Nachtigal, Amy CFO 8169323318	7/24/2017 6:51 PM
Contacts	Primary Contact	Insert			Little, Jeff Director of Pharmacy 8169322408	7/24/2017 6:51 PM
Addresses	Main Address	Insert			4321 Washington Street Medical Plaza III Suite 2100 Kansas City, MO 64111	7/24/2017 6:51 PM
Details	Last Recertification Date	Update		8/31/2015 12:00:00 AM	8/16/2016 12:00:00 AM	8/16/2016 10:31 AM
Details	Last Recertification Date	Update			8/31/2015 12:00:00 AM	8/31/2015 2:34 PM
Dates	Participating Approval Date	Update			12/8/2014 12:00:00 AM	12/8/2014 6:07 PM
Details	State	Update		Pending	Active	12/8/2014 6:07 PM
Dates	Start Date	Update			1/1/2015 12:00:00 AM	12/8/2014 6:07 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_47546	DSH260138F	10/17/2014 7:11 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_47546	10/15/2014 2:55 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	10/15/2014 2:55 PM
Medicaid Billing	Medicaid: Number	Insert			010326106	10/15/2014 2:55 PM
Medicaid Billing	Medicaid: State	Insert			MO	10/15/2014 2:55 PM
Medicaid Billing	NPI: Number	Insert			1063494177	10/15/2014 2:55 PM
Details	Last Recertification Date	Insert				10/15/2014 2:55 PM
Details	Grant Number	Insert				10/15/2014 2:55 PM
Details	340B ID	Insert				10/15/2014 2:55 PM
Details	Is Authorizing Official EHB Data	Insert				10/15/2014 2:55 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/15/2014 2:55 PM
Details	Medicare Provider Number	Insert			260138	10/15/2014 2:55 PM
Details	Entity Name	Insert			ST. LUKES HOSPITAL OF KANSAS CITY	10/15/2014 2:55 PM
Details	Program Code	Insert			DSH	10/15/2014 2:55 PM
Details	Entity Subname	Insert			Saint Luke's Heart Transplant Clinic	10/15/2014 2:55 PM
Dates	Participating Approval Date	Insert				10/15/2014 2:55 PM
Details	State	Insert			Pending	10/15/2014 2:55 PM
Dates	Registration Date	Insert			10/15/2014 12:00:00 AM	10/15/2014 2:55 PM
Dates	Signed By Date	Insert			10/15/2014 12:00:00 AM	10/15/2014 2:55 PM
Dates	Start Date	Insert				10/15/2014 2:55 PM
Terminations	Termination Comments	Insert				10/15/2014 2:55 PM
Terminations	Termination Date	Insert				10/15/2014 2:55 PM
Terminations	Termination Effective Date	Insert				10/15/2014 2:55 PM
Terminations	Termination Reason	Insert				10/15/2014 2:55 PM