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Christopher Greater Area Rural Health Planning Corporation

Organization Active NPI Federally Qualified Health Center (FQHC) · Shawneetown, IL

NPI 1285614867 · NPPES record last updated Jan 30, 2026

Key facts

NPI
1285614867
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Practice address
9525 Gold Hill Road
Shawneetown Health Care Clinic
Shawneetown, IL 62984
Phone
(618) 269-3815
Fax
(618) 269-3274
NPI assigned
Jan 19, 2006
Organization subpart
No

Authorized official

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

Owned or controlled facilities with NPI records 3

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

Other NPIs on the same Medicare enrollment 15

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

Other NPIs with the same Medicare PAC ID 15

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

Corporate family (same tax ID) 18

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

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

Practitioners 55

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

View all 55

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Federally qualified health center certification: CCN 141940

Legal name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
SHAWNEETOWN HEALTHCARE CLINC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 19, 2003
Last certification
Jun 19, 2003
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Jun 8, 1977 in IL
Enrollment address
9525 Gold Hill Rd
Shawneetown, IL 62984-3659
Related CCNs
140010

All disclosed owners & managing parties 11

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 Director Jun 6, 2003
Gary Kelly
Individual 		Corporate Director Jan 1, 2014
Ruth Stanford
Individual 		Corporate Director Jun 6, 2003
Paul J Cruz
Individual 		Corporate Director Mar 31, 2014
Marian Smith-Furlow
Individual 		Corporate Director Jan 1, 2014
Kimberly a. Mitroka
Individual 		Corporate Director Jun 6, 2003
W-2 Managing Employee
Ceo		 Jun 6, 2003
Thomas Konopasek
Individual 		Corporate Director Mar 23, 2015
Richard Schablowsky
Individual 		Corporate Director Mar 24, 2004
Dorothy Deangelo
Individual 		Corporate Director Jun 6, 2003
Lisa Hopkins
Individual 		Corporate Director Apr 1, 2008
Gerald Hearring
Individual 		Corporate Director Mar 23, 2003

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

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20030606000006 IL Part a Provider - Federally Qualified Health Center (FQHC) 8224947387 Practice locations: Shawneetown, IL
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…

National Provider Directory

Tax ID family
Christopher Rural HLTH (19 organizations share this tax ID)

Locations

4241 State Highway 14
Christopher, IL 62822
Phone (618) 724-2136

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363LF0000X

Addresses

Primary practice location

9525 Gold Hill Road
Shawneetown Health Care Clinic
Shawneetown, IL 62984

Mailing address

PO Box 155
Christopher Greater Area Rural Health Planning Corp
Christopher, IL 62822
Phone (618) 724-2401

Other names

  • Shawneetown Healthcare Clinic Other name

Other providers in Shawneetown, IL

All providers in Shawneetown, IL · Federally Qualified Health Center (FQHC) in Illinois

Sources for this page

Verify at the official NPI Registry.