NPIMap

Organization Active NPI

Betty Jean Kerr People's Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
National Provider Identifier
1194797787
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
072100 Issued in MO
Legal business name
BETTY JEAN KERR PEOPLE'S HEALTH CENTERS
Practice address
5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone
(314) 367-7848
Fax
(314) 367-2985
NPI assigned
Feb 7, 2006
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Dwayne Butler
Title
President & Ceo
Phone
(314) 367-7848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 072100 MO Primary

Addresses

Primary practice location

5701 Delmar Blvd
Saint Louis, MO 63112-2617

Mailing address

5701 Delmar Blvd
Saint Louis, MO 63112-2617
Phone (314) 367-7848

Other identifiers 2

IdentifierTypeStateIssuer
500543327MedicaidMO
1194797787MedicaidMO

Other names 1

  • People's Health Centers, Incorporated Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031107000168 MO Part B Supplier - Clinic/Group Practice 5991618837 Receives reassigned benefits from 51 practitioners
3 other NPIs on this enrollment
Practice locations: Ferguson, MO; Florissant, MO; Saint Louis, MO
O20080507000246 MO Part A Provider - Federally Qualified Health Center (FQHC) 5991618837 Practice locations: Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194797787. Details of each certification follow.

Federally qualified health center certification: CCN 261805

Legal name
BETTY JEAN KERR PEOPLES HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 7, 1974 in MO
Enrollment address
5701 Delmar Blvd
Saint Louis, MO 63112-2617

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Dwayne Butler Individual Corporate OfficerPresident & Ceo Apr 7, 2008
W-2 Managing EmployeePresident & Ceo Apr 7, 2008 100%
Operational/Managerial ControlPresident & Ceo Apr 7, 2008 100%
Daniel W. Whitehead Individual Corporate DirectorBoard Member Jun 30, 1989
Stacy a Jefferson Individual Corporate DirectorBoard Member Feb 20, 2020
Michael Jamison Individual Corporate DirectorBoard Member Jun 16, 2016
Mark Sanford Individual Corporate OfficerExecutive Vice President Dec 10, 2007
W-2 Managing EmployeeExecutive Vice-President Dec 10, 2007
Herman Noah Individual Corporate OfficerTreasurer, Board of Directors Apr 17, 2008
Corporate DirectorBoard Member Jul 22, 1988
Mark R. Bradshaw Miller Individual Corporate DirectorBoard Member Aug 21, 2008
Brian C Williams Individual Corporate DirectorBoard Member Jul 16, 2015
Rodney Wead Individual Corporate DirectorBoard Member May 15, 2008
Doretha Gilbert Individual Corporate OfficerSecretary, Board of Directors Jul 20, 2011
Corporate DirectorBoard Member May 15, 2008
Charles Saulsberry Individual Corporate DirectorBoard Member Oct 18, 2018
Richard King Individual Corporate OfficerChairman, Board of Directors Sep 25, 2021
Corporate DirectorBoard Member Oct 20, 2016

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Peoples Healthcare ServicesFerguson, MO, CCN 261151 Federally qualified health center Operational/Managerial Control (100%) Aug 7, 1974

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1194797787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617",
            "telephone_number": "314-367-7848",
            "fax_number": "314-367-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 DELMAR BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631122617",
            "telephone_number": "314-367-7848",
            "fax_number": "314-367-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTY JEAN KERR PEOPLE'S HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "314-367-7848"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MO",
            "license": "072100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500543327",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194797787",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "People's Health Centers, Incorporated",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.