NPIMap

Organization Active NPI

Family Care Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
National Provider Identifier
1508867508
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY CARE HEALTH CENTERS
Practice address
401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone
(314) 481-1615
Fax
(314) 353-1310
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Robin S Jones
Title
Chief Financial Officer
Phone
(314) 481-1615

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MO
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

401 Holly Hills Ave
Saint Louis, MO 63111-2410

Mailing address

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 481-1615

Other identifiers 4

IdentifierTypeStateIssuer
500968425MedicaidMO
500968417MedicaidMO
606023604MedicaidMO
500858417MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
O20021218000023 MO Part A Provider - Federally Qualified Health Center (FQHC) 7911815097 Practice locations: Saint Louis, MO
O20041206000646 MO Part B Supplier - Clinic/Group Practice 7911815097 Receives reassigned benefits from 54 practitioners
Practice locations: Saint Louis, MO
O20141113000118 MO Part A Provider - Federally Qualified Health Center (FQHC) 7911815097 1 other NPI on this enrollment
Practice locations: Saint Louis, MO
O20210115001756 MO Part A Provider - Federally Qualified Health Center (FQHC) 7911815097 Practice locations: Saint Louis, MO
O20260416001251 MO Part A Provider - Federally Qualified Health Center (FQHC) 7911815097 Practice locations: Saint Louis, MO

Federally qualified health center certification: CCN 261807

Legal name
FAMILY CARE HEALTH CENTERS
Doing business as
FAMILY CARE HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 31, 1992
Last certification
Jan 31, 1992
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Nov 12, 1991 in MO
Enrollment address
401 Holly Hills Ave
Saint Louis, MO 63111-2410

Federally qualified health center certification: CCN 261092

Legal name
FAMILY CARE HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 16, 2014
Last certification
Dec 16, 2014
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Enrollment address
1001 Lynch St
Saint Louis, MO 63118-1818

Federally qualified health center certification: CCN 791007

Legal name
FAMILY CARE HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 15, 2021
Last certification
Jan 15, 2021
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
2717 Sidney St
Saint Louis, MO 63104-2329

Federally qualified health center certification: CCN 791932

Legal name
FAMILY CARE HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 2026
Last certification
May 1, 2026
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
3824 S Grand Blvd
Saint Louis, MO 63118-3412

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

6313 Michigan Ave
Saint Louis, MO 63111

6827 S Broadway
Saint Louis, MO 63111

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Tracy McCreery Individual Corporate Director Jan 1, 2013
Corporate DirectorDirector Jan 1, 2013
Kasan Moorhead Individual Corporate Director Jan 1, 2019
Corporate DirectorBoard Treasurer Jan 1, 2019
Lois Woods-Ward Individual Corporate Director Jan 1, 2021
Corporate DirectorDirector Jan 1, 2021
Amir Tibbs Individual Corporate Director Jan 1, 2022
Corporate DirectorBoard Secretary Jan 1, 2022
Sue Lauritsen Individual Corporate Director Jan 1, 1991
Corporate DirectorBoard Vice-President Jan 1, 1991
Corporate DirectorBoard Vice-President Jan 1, 1999
Kevin Maddox Individual Operational/Managerial ControlChief Financial Officer Jun 8, 2020
Corporate OfficerChief Financial Officer Jun 8, 2020
W-2 Managing Employee Jun 8, 2020
Wilma Schmitz Individual Corporate Director Jan 1, 2002
Corporate DirectorBoard President Jan 1, 2002
V.J. Dickson Individual Corporate Director Jan 1, 2011
Corporate Director Jan 1, 2017
Aramide Ayorinde Individual Corporate Officer Jan 17, 2023
W-2 Managing Employee Jan 17, 2023
Corporate OfficerChief Executive Officer Jan 17, 2023
W-2 Managing EmployeeCeo Jan 17, 2023
Kevin Syberg Individual Corporate Director Jan 1, 2016
Corporate Director Jan 1, 2018
Catherine Nolan Individual Corporate Director Jan 1, 1999
Shaowei Dai Individual Corporate Director Jan 1, 2016
Raven Pugh Individual Corporate DirectorDirector Dec 17, 2024
Rikki Watts Individual Corporate DirectorDirector Jan 17, 2024
Robert Arduthnot Individual Corporate DirectorDirector Oct 1, 2025
Patricia Whelan Individual Corporate DirectorDirector Jan 17, 2024
Shedrick Kelley Individual Corporate DirectorDirector Jan 17, 2024
Brett Maricque Individual Corporate DirectorDirector Jan 17, 2024
Barbara L Prosser Individual Corporate DirectorDirector Jan 17, 2024
Robin Jones Individual Corporate OfficerChief Financial Officer Jul 28, 2025
Chelsey Carter Individual Corporate DirectorDirector Jan 17, 2024

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1508867508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-481-1615",
            "fax_number": "314-353-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-481-1615",
            "fax_number": "314-353-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "314-481-1615"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500968425",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500968417",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "606023604",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500858417",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.