NPIMap

Organization Active NPI

Betty Jean Kerr People'S Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
National Provider Identifier
1750625257
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BETTY JEAN KERR PEOPLE'S HEALTH CENTERS
Doing business as
Vashon High School
Practice address
3035 Cass Ave
Saint Louis, MO 63106-1533
Phone
(314) 367-7848
Fax
(314) 367-2985
NPI assigned
Nov 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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 Primary

Addresses

Primary practice location

3035 Cass Ave
Saint Louis, MO 63106-1533

Mailing address

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

Other names 1

  • Vashon High School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 261090

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
VASHON HIGH SCHOOL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 26, 2014
Last certification
Aug 26, 2014
Ownership / control type
For profit – corporation
Facility address
3035 Cass Ave
Saint Louis, MO 63106

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1750625257",
    "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": "3035 CASS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061533",
            "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": "2012-11-21",
        "last_updated": "2014-10-31",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vashon High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.