Covered Entity Details

DSH260138X ST. LUKE'S HOSPITAL OF KANSAS CITY (Active) - information as of 6/1/2025 3:57:52 AM

Main Details

Name

ST. LUKE'S HOSPITAL OF KANSAS CITY

Subdivision Name

SAINT LUKES HOSPITAL INFUSION CENTE - Oncology

Type

Disproportionate Share Hospital

Rural

340B ID

DSH260138X

Medicare Provider Number

260138

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/7/2023

Participating Start Date

10/1/2023

Participating Approval Date

8/4/2023

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

5844 NW BARRY RD
STE 40
KANSAS CITY, MO 64154-1483

Billing Address

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

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	010326106,600012785	1063494177,1134566409

Shipping Addresses

Same as Street Address

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		8/22/2024 7:07:03 PM	8/22/2024 7:07 PM
Addresses	Billing Address	Insert	Group Change Request		Saint Luke's Hospital PO Box 5870 Kansas City, MO 64171	2/21/2024 11:53 AM
Details	State	Update		Approved	Active	10/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	8/4/2023 9:02 AM
Details	340B ID	Update	New Registration		DSH260138X	8/4/2023 9:02 AM
Details	Entity Name	Update	New Registration	SAINT LUKES HOSPITAL OF KANSAS CITY	ST. LUKE'S HOSPITAL OF KANSAS CITY	8/4/2023 9:02 AM
Details	Entity Subname	Update	New Registration	SAINT LUKES HOSPITAL INFUSION CENTE	SAINT LUKES HOSPITAL INFUSION CENTE - Oncology	8/4/2023 9:02 AM
Dates	Participating Approval Date	Update	New Registration		8/4/2023 9:02:31 AM	8/4/2023 9:02 AM
Details	State	Update	New Registration	Pending	Approved	8/4/2023 9:02 AM
Dates	Signed By Date	Update	New Registration		7/7/2023 4:35:08 PM	8/4/2023 9:02 AM
Dates	Start Date	Update	New Registration		10/1/2023 12:00:00 AM	8/4/2023 9:02 AM
Addresses	Main Address	Insert	New Registration		5844 NW BARRY RD STE 40 KANSAS CITY, MO 64154-1483	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		010326106	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		600012785	7/7/2023 4:08 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		MO	7/7/2023 4:08 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1063494177	7/7/2023 4:08 PM
Medicaid Billing	NPI: State	Insert	New Registration		MO	7/7/2023 4:08 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1134566409	7/7/2023 4:08 PM
Medicaid Billing	NPI: State	Insert	New Registration		MO	7/7/2023 4:08 PM
Contacts	Authorizing Official	Insert	New Registration		Nachtigal, Amy CFO Saint Luke's Hospital of Kansas City 8169323318	7/7/2023 4:08 PM
Contacts	Primary Contact	Insert	New Registration		Little, Jeff Director of Pharmacy Saint Luke's Hospital 8169322408	7/7/2023 4:08 PM
Details	Assistance Received From Date	Insert	New Registration			7/7/2023 4:08 PM
Details	Assistance Received To Date	Insert	New Registration			7/7/2023 4:08 PM
Details	Last Recertification Date	Insert	New Registration			7/7/2023 4:08 PM
Details	Grant Number	Insert	New Registration			7/7/2023 4:08 PM
Details	340B ID	Insert	New Registration			7/7/2023 4:08 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/7/2023 4:08 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/7/2023 4:08 PM
Details	Medicare Provider Number	Insert	New Registration		260138	7/7/2023 4:08 PM
Details	Entity Name	Insert	New Registration		SAINT LUKES HOSPITAL OF KANSAS CITY	7/7/2023 4:08 PM
Details	NOFO Number	Insert	New Registration			7/7/2023 4:08 PM
Details	Program Code	Insert	New Registration		DSH	7/7/2023 4:08 PM
Details	Entity Subname	Insert	New Registration		SAINT LUKES HOSPITAL INFUSION CENTE	7/7/2023 4:08 PM
Dates	Participating Approval Date	Insert	New Registration			7/7/2023 4:08 PM
Details	State	Insert	New Registration		Pending	7/7/2023 4:08 PM
Dates	Registration Date	Insert	New Registration		7/7/2023 4:08:51 PM	7/7/2023 4:08 PM
Dates	Signed By Date	Insert	New Registration			7/7/2023 4:08 PM
Dates	Start Date	Insert	New Registration			7/7/2023 4:08 PM
Terminations	Termination Comments	Insert	New Registration			7/7/2023 4:08 PM
Terminations	Termination Date	Insert	New Registration			7/7/2023 4:08 PM
Terminations	Termination Effective Date	Insert	New Registration			7/7/2023 4:08 PM
Terminations	Termination Reason	Insert	New Registration			7/7/2023 4:08 PM