County of St Louis Division of Fiscal Management
Organization Active NPI Federally Qualified Health Center (FQHC) · Berkeley, MO
NPI 1184519506 · NPPES record last updated Aug 26, 2025
Key facts
- NPI
- 1184519506
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT
- Practice address
- 6121 N Hanley Rd
Berkeley, MO 63134-2003 - Phone
- (314) 615-0500
- Fax
- (314) 615-8303
- NPI assigned
- Jun 9, 2025
- Organization subpart
- Yes
- Parent organization (as reported)
- COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT
Authorized official
- Name
- Denise Wilson
- Title
- Revenue Manager
- Phone
- (314) 615-0877
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 4
Practitioners 175
-
Thomas C Bailey, MD
-
Robert D Baird, M.D.
-
Kim Lesley Ferguson, MSW, MTS
-
Nicole Gloor, MD
-
Patrick Miller, DO
-
Charles H. Tadros, M.D.
-
Jessica Wagner, PA-C
-
Molly Jo Nelsen, D.O.
-
Patricia Edwards-Parrish, NURSE PRACTITIONER
-
Leslie A McCloskey, M.D.
-
Kathleen A Bernhard, M.D.
-
Brenda D. Bush, NP-C
-
Michael Donovan, M.D.
-
Theresa Drallmeier, M.D.
-
Christopher Elliott, LCSW
-
Anna Cristina Fernandez, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2332416 | John C Murphy Health Center | Provider-performed microscopy | Oct 19, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Federally qualified health center certification: CCN 791931
- Legal name
- COUNTY OF ST LOUIS DIVISION OF FISCAL MANAGEMENT
- Doing business as
- JOHN C MURPHY HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 8, 2026
- Last certification
- Jan 8, 2026
- Ownership / control type
- For profit – corporation
- Organization structure
- Government · Non-profit
- Enrollment address
- 6121 N Hanley Rd
Saint Louis, MO 63134-2003
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Ladevich |
Corporate Director |
Jun 1, 2025 | |
| W-2 Managing Employee |
Jun 1, 2025 | ||
| Danny O'Neill |
Corporate Officer |
Jun 1, 2025 | |
| Blake Vogelweid |
Corporate Officer |
Jun 1, 2025 | |
| Denise Wilson |
W-2 Managing Employee |
Jun 1, 2025 | |
| James Singer |
Corporate Officer |
Jun 1, 2025 | |
| Robert a Brennan |
Corporate Officer |
Jun 1, 2025 | |
| David Noble |
Corporate Officer |
Jun 1, 2025 | |
| Courtney Berg |
Corporate Officer |
Jun 1, 2025 | |
| Marcia Mellitz |
Corporate Officer |
Jun 1, 2025 | |
| Demaris Ridgell |
Corporate Officer |
Jun 1, 2025 | |
| Andrew Shaughnessy |
Corporate Officer |
Jun 1, 2025 | |
| Kaylin Lyles |
Corporate Officer |
Jun 1, 2025 | |
| Lori Callander |
Corporate Officer |
Jun 1, 2025 | |
| Jay Coffman |
Corporate Officer |
Jun 1, 2025 | |
| Marsha Stayton |
Corporate Officer |
Jun 1, 2025 | |
| Trecia Thacker |
Corporate Officer |
Jun 1, 2025 | |
| Dionne Jones |
Corporate Officer |
Jun 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20260108000312 | MO | Part a Provider - Federally Qualified Health Center (FQHC) | 0941285720 | Practice locations: Saint Louis, MO |
National Provider Directory
- Tax ID family
- St Louis County Government
- Part of
- St Louis County Government
Locations
6121 N Hanley Rd
#C
Saint Louis, MO 63134
Phone (314) 615-0500
4000 Jennings Station Rd
Saint Louis, MO 63121
Phone (314) 679-7800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
6121 N Hanley Rd
Berkeley, MO 63134-2003
Mailing address
6121 N Hanley Rd
Berkeley, MO 63134-2003
Phone (314) 615-0877
Other names
- John C. Murphy Health Center
Other providers in Berkeley, MO
- Bradley Edward Burns
- Caring Partners Medical Supply LLC
- Danielle Theresa Chavez
- City of Berkeley
- Tanquerae Kissy-Virginia Cole
- Amanda Evans
- Marlea Finch
- Mary G Fitzgerald
- Raven Forrest
- Genuine Adult Daycare Services LLC
All providers in Berkeley, MO · Federally Qualified Health Center (FQHC) in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.