NPIMap

Organization Active NPI

Christopher Greater Area Rural Health Planning Corp

  • Federally Qualified Health Center (FQHC)
  • Flora, IL
National Provider Identifier
1528048105
Registry record updated Jan 23, 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 CORP
Practice address
165 Kinnaman Dr
Flora, IL 62839-4204
Phone
(618) 662-8386
Fax
(618) 662-4338
NPI assigned
Jan 19, 2006
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Kim A Mitroka
Title
President Ceo
Phone
(618) 724-2401

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

165 Kinnaman Dr
Flora, IL 62839-4204

Mailing address

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

Other names 1

  • Clay Medical Center Other name

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…
O20061018000544 IL Part A Provider - Federally Qualified Health Center (FQHC) 8224947387 Practice locations: Flora, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528048105. Details of each certification follow.

Federally qualified health center certification: CCN 141820

Legal name
CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Doing business as
CLAY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 8, 1977 in IL
Enrollment address
165 Kinnaman Dr
Flora, IL 62839-4204

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
14D0682285Christopher Rural HLTH Plan Corp/Clay Med Center165 Kinnaman Dr, Flora, IL 62839Certificate of waiverFeb 3, 2028

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

1564 S Washington St
Du Quoin, IL 62832
Phone (618) 542-8702

9525 Gold Hill Rd
Shawneetown, IL 62984
Phone (618) 269-3454

Ownership & related parties

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 DirectorSecretary/Treasure Mar 1, 2010
Gary Kelly Individual Corporate DirectorVice-Chair Mar 19, 2012
Ruth Stanford Individual Corporate Director Mar 1, 2010
Paul J Cruz Individual Corporate Director Mar 19, 2016
Marian Smith-Furlow Individual Corporate Director Mar 19, 2013
Kimberly a. Mitroka Individual Corporate OfficerCeo/President Oct 1, 2006
W-2 Managing EmployeeCeo Oct 1, 2006
Thomas Konopasek Individual Corporate Director Mar 19, 2015
Richard Schablowsky Individual Corporate Director Mar 1, 2010
Dorothy Deangelo Individual Corporate Director Mar 1, 2010
Lisa Hopkins Individual Corporate Director Mar 1, 2009
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 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 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1528048105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORP",
            "address_2": "PO BOX 155",
            "city": "CHRISTOPHER",
            "state": "IL",
            "postal_code": "62822",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 KINNAMAN DR",
            "city": "FLORA",
            "state": "IL",
            "postal_code": "628394204",
            "telephone_number": "618-662-8386",
            "fax_number": "618-662-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "MITROKA",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "618-724-2401"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay Medical Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Clay Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flora, IL

Sources for this page

Verify at the official NPI Registry.