| Betty Jean Kerr People's Health Centers | |
|
5701 Delmar Blvd Saint Louis MO 63112-2617 | |
| (314) 367-7848 | |
| (314) 367-2985 |
| Full Name | Betty Jean Kerr People's Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 5701 Delmar Blvd, Saint Louis, Missouri |
| Authorized Official Name and Position | Dwayne Butler (PRESIDENT & CEO) |
| Authorized Official Contact | 3143677848 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Betty Jean Kerr People's Health Centers 5701 Delmar Blvd Saint Louis MO 63112-2617 Ph: (314) 367-7848 | Betty Jean Kerr People's Health Centers 5701 Delmar Blvd Saint Louis MO 63112-2617 Ph: (314) 367-7848 |
| NPI Number | 1194797787 |
|---|---|
| Provider Enumeration Date | 02/07/2006 |
| Last Update Date | 05/13/2014 |
| Medicare PECOS PAC ID | 5991618837 |
|---|---|
| Medicare Enrollment ID | O20031107000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194797787 | NPI | - | NPPES |
| 1194797787 | Medicaid | MO | |
| 500543327 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 072100 (Missouri) | Primary |
| Provider Name | Linda Tobias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578678652 PECOS PAC ID: 5395642870 Enrollment ID: I20031213000013 |
| Provider Name | John S Daniels |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104978964 PECOS PAC ID: 4284606997 Enrollment ID: I20040811001272 |
| Provider Name | Linda R Winterberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295706513 PECOS PAC ID: 0840256483 Enrollment ID: I20041206000994 |
| Provider Name | Neoritha Humphrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780872317 PECOS PAC ID: 9436188315 Enrollment ID: I20050810001258 |
| Provider Name | Gabrielle Paulette Satterfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093709982 PECOS PAC ID: 9234154741 Enrollment ID: I20051013000046 |
| Provider Name | Kirk A Washington |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1255447090 PECOS PAC ID: 5890716393 Enrollment ID: I20051213000155 |
| Provider Name | Ardell Mays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821056888 PECOS PAC ID: 9335159086 Enrollment ID: I20060426000365 |
| Provider Name | Jacquelyn R Mcfadden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891809646 PECOS PAC ID: 7517962244 Enrollment ID: I20061002000128 |
| Provider Name | Daniel W. Whitehead |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245291590 PECOS PAC ID: 3072611912 Enrollment ID: I20070531000241 |
| Provider Name | Carol Huddleston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184824427 PECOS PAC ID: 4183715022 Enrollment ID: I20070808000047 |
| Provider Name | Adolphus C Favors |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700831732 PECOS PAC ID: 1658442058 Enrollment ID: I20080612000245 |
| Provider Name | Robert J Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316909872 PECOS PAC ID: 3870627615 Enrollment ID: I20100817000042 |
| Provider Name | Igor Brondz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750341152 PECOS PAC ID: 7618001280 Enrollment ID: I20100818000328 |
| Provider Name | Fred J Balis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861447625 PECOS PAC ID: 1850399718 Enrollment ID: I20100827000769 |
| Provider Name | Vickie C Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255363826 PECOS PAC ID: 3870779325 Enrollment ID: I20110517000627 |
| Provider Name | Jacqueline G Harvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629004627 PECOS PAC ID: 2264605948 Enrollment ID: I20111024000799 |
| Provider Name | Sadashiv D Parwatikar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992793145 PECOS PAC ID: 8820234701 Enrollment ID: I20130419000173 |
| Provider Name | Kimberly L Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1093873721 PECOS PAC ID: 1456405935 Enrollment ID: I20130606000822 |
| Provider Name | John H Giroux |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396774485 PECOS PAC ID: 8325262652 Enrollment ID: I20150902001961 |
| Provider Name | Nawal M Ahmed |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1710989504 PECOS PAC ID: 2668777590 Enrollment ID: I20160301001968 |
| Provider Name | Gita J Malur |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578698924 PECOS PAC ID: 5092765610 Enrollment ID: I20161102000232 |
| Provider Name | Whitney Danillia Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841725546 PECOS PAC ID: 9830449818 Enrollment ID: I20180912003269 |
| Provider Name | Mia R Sing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629560297 PECOS PAC ID: 2062748080 Enrollment ID: I20190730000923 |
| Provider Name | Helen W Garner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215191861 PECOS PAC ID: 4688625718 Enrollment ID: I20200225001012 |
| Provider Name | Emily J Bahram Ahi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265832075 PECOS PAC ID: 4981825841 Enrollment ID: I20210506001697 |
| Provider Name | Ryan M Goergen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1487059721 PECOS PAC ID: 9739478454 Enrollment ID: I20210526000551 |
| Provider Name | Ackeilia K Heatrice |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1609003060 PECOS PAC ID: 7517188428 Enrollment ID: I20210602001977 |
| Provider Name | Pooja P Dara |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1285202531 PECOS PAC ID: 2163816067 Enrollment ID: I20220217002687 |
| Provider Name | Carlos E Pirela Gomez |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1942441563 PECOS PAC ID: 0547556631 Enrollment ID: I20220627002618 |
| Provider Name | Demetre D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821704974 PECOS PAC ID: 3678948882 Enrollment ID: I20230331000224 |
| Provider Name | Surbhi C Jain |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043877301 PECOS PAC ID: 0941536445 Enrollment ID: I20230627000985 |
| Provider Name | Nicole M Gloor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437619269 PECOS PAC ID: 0143555995 Enrollment ID: I20230627001414 |
| Provider Name | Luke J Brown |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1336872985 PECOS PAC ID: 0648615047 Enrollment ID: I20240226000622 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
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Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
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