NPIMap

Organization Active NPI

Carestl Health

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1972596088
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CARESTL HEALTH
Practice address
5471 Dr. Martin Luther King
Saint Louis, MO 63112-4265
Phone
(314) 367-5820
Fax
(314) 367-7010
NPI assigned
Aug 24, 2005
Last updated
Aug 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Authorized official

Name
Mrs. Angela R Clabon, MBA
Title
Ceo
Phone
(314) 367-5820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

5471 Dr. Martin Luther King
Saint Louis, MO 63112-4265

Mailing address

PO Box 772971
Chicago, IL 60677-0271
Phone (314) 898-1268

Other identifiers 1

IdentifierTypeStateIssuer
500622915MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031219000441 MO Part B Supplier - Clinic/Group Practice 1557269289 Receives reassigned benefits from 42 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jennings, MO; Saint Louis, MO; Saint Ann, MO
O20100616000478 MO Part A Provider - Federally Qualified Health Center (FQHC) 1557269289 Practice locations: Saint Louis, MO
O20200810001517 MO Part B Supplier - Pharmacy 1557269289 4 other NPIs on this enrollment
Practice locations: Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972596088. Details of each certification follow.

Federally qualified health center certification: CCN 261808

Legal name
CARESTL HEALTH
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
Oct 17, 1969 in MO
Enrollment address
5471 Dr Martin Luther King Dr
Saint Louis, MO 63112-4265

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

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory

Locations

5541 Riverview Blvd
Saint Louis, MO 63120
Phone (314) 389-4566

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
William Dailey Individual Corporate Director Apr 27, 2023
Eva Marie Aagaard Individual Corporate Director Apr 27, 2023
Randi Foraker Individual Corporate Director Apr 27, 2023
Latrell Hayes Individual Corporate Director Apr 27, 2023
Darrell Hudson Individual Corporate Director Apr 27, 2023
Saint Rice Individual Corporate Director Apr 27, 2023
Tiffany Paul Individual Corporate Director Apr 27, 2023
Sheila Stuart Individual Corporate Director Apr 27, 2023
Vida Paul-Perry Individual Corporate Director Apr 27, 2023
Bonnie Woods Individual Corporate Director Apr 27, 2023
Flora Robinson Individual Corporate Director Apr 27, 2023
Chrisena Brown Individual Corporate Director Apr 27, 2023
Karen Jones Individual Corporate Director Apr 27, 2023
Angela Archibald-Clabon Individual Corporate OfficerCeo Dec 18, 2013 100%
W-2 Managing EmployeeCeo Dec 18, 2013 100%
Dara Webb Individual Corporate Director Apr 27, 2023
Aaron Craig Individual Corporate Director Apr 27, 2023

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1972596088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772971",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770271",
            "telephone_number": "314-898-1268",
            "fax_number": "855-298-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 DR. MARTIN LUTHER KING",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631124265",
            "telephone_number": "314-367-5820",
            "fax_number": "314-367-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESTL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "CLABON",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-367-5820",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500622915",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.