NPIMap

Organization Active NPI

Christopher Greater Area Rural Health Planning Corporation

Doing business as Mt. Vernon Health & Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, IL
National Provider Identifier
1083592604
Registry record updated Jan 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
Mt. Vernon Health & Wellness Center
Practice address
4117 S Water Tower PL Ste D
Mount Vernon, IL 62864-6567
Phone
(618) 242-4848
NPI assigned
Aug 22, 2025
Last updated
Jan 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2026

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

Authorized official

Name
Kimberly Mitroka
Title
President/Ceo
Phone
(618) 724-2401

Specialties & licenses 1

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

Addresses

Primary practice location

4117 S Water Tower PL Ste D
Mount Vernon, IL 62864-6567

Mailing address

PO Box 155
Christopher, IL 62822-0155
Phone (618) 724-2401

Other names 1

  • Mt. Vernon Health & Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040109000561 IL Part B Supplier - Clinic/Group Practice 8224947387 Receives reassigned benefits from 71 practitioners
20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Shawneetown, IL; Sesser, IL; Mount Vernon, IL; Johnston City, IL; Flora, IL; Fairfield, IL; Eldorado, IL; Du Quoin, IL…
O20251030001979 IL Part A Provider - Federally Qualified Health Center (FQHC) 8224947387 Practice locations: Mount Vernon, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083592604. Details of each certification follow.

Federally qualified health center certification: CCN C41052

Legal name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
MT VERNON HEALTH AND WELLNESS CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 25, 2025
Last certification
Sep 25, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4117 S Water Tower PL
Ste D
Mount Vernon, IL 62864-6567

Other NPIs with the same Medicare PAC ID 15

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

View all 15

Other NPIs on the same Medicare enrollment 15

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

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2334780Mt Vernon Health & Wellness Ctr4117 S Water Tower Place - Ste D, Mount Vernon, IL 62864Certificate of waiverDec 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Christopher Rural Health Planning Corp20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

4241 Highway 14 W
Christopher, IL 62822
Phone (618) 724-1684

607 4th St
Eldorado, IL 62930
Phone (618) 273-2951

613 S Marshall Ave
MC Leansboro, IL 62859
Phone (618) 643-3956

613 S Marshall Ave
McLeansboro, IL 62859
Phone (618) 643-3956

1907 Broadway St
Mount Vernon, IL 62864
Phone (618) 244-6544

27 Circle St
Zeigler, IL 62999
Phone (618) 596-2411

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
John Hosselton Individual Corporate OfficerBoard Member Mar 25, 1998
Paul J Cruz Individual Corporate DirectorBoard Member Mar 25, 2016
Marian Smith-Furlow Individual Corporate OfficerBoard Member Mar 25, 2015
Kimberly a. Mitroka Individual Corporate DirectorPresident/Ceo May 22, 2006
W-2 Managing EmployeePresident May 22, 2006
Richard Schablowsky Individual Corporate OfficerBoard Member Mar 25, 1998
Lisa Hopkins Individual Corporate OfficerBoard Member Mar 23, 2008
Gerald Hearring Individual Corporate DirectorBoard Member Mar 23, 2003
Patricia Marie Salmo Individual Corporate DirectorBoard Member Nov 9, 2023

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Mt. Vernon Community Health CenterMt Vernon, IL, CCN 141022 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2005
Johnston City Community Health CenterJohnston City, IL, CCN 141065 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 1, 2009
Crhpc Comprehensive Behavioral Health ServicesDu Quoin, IL, CCN 781074 Federally qualified health center Operational/Managerial Control (100%) Jul 8, 1977

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768780800000",
    "number": "1083592604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "628220155",
            "telephone_number": "618-724-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 S WATER TOWER PL STE D",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646567",
            "telephone_number": "618-242-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2026-01-19",
        "certification_date": "2026-01-19",
        "status": "A",
        "authorized_official_last_name": "MITROKA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "618-724-2401"
    },
    "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": "Mt. Vernon Health & Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.